Healthcare Provider Details

I. General information

NPI: 1932197068
Provider Name (Legal Business Name): BILL RALPH SYKES JR. DC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15140 HWY 150 WE
COLDSPRINGS TX
77331
US

IV. Provider business mailing address

PO BOX 1007
COLDSPRING TX
77331-1007
US

V. Phone/Fax

Practice location:
  • Phone: 936-653-2958
  • Fax: 936-653-2959
Mailing address:
  • Phone: 936-653-2958
  • Fax: 936-653-2959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number9825
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: