Healthcare Provider Details

I. General information

NPI: 1669085452
Provider Name (Legal Business Name): DAYANA PAOLA BUCARELLO MONTOYA DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2020
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 DISCOVERY BLVD STE 207
CEDAR PARK TX
78613-2288
US

IV. Provider business mailing address

1704 EAGLES WAY
LEANDER TX
78641-8810
US

V. Phone/Fax

Practice location:
  • Phone: 512-934-1703
  • Fax: 512-359-5675
Mailing address:
  • Phone: 512-696-2040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number14465
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: