Healthcare Provider Details

I. General information

NPI: 1750979415
Provider Name (Legal Business Name): JULIA ELLEN AUGUSTYNIAK DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2021
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6851 VIRGINIA PKWY STE 212
MCKINNEY TX
75071-5856
US

IV. Provider business mailing address

2800 PAINTED LAKE CIR UNIT 305
THE COLONY TX
75056-4367
US

V. Phone/Fax

Practice location:
  • Phone: 734-308-2729
  • Fax:
Mailing address:
  • Phone: 734-308-2729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number15003
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301011040
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: