Healthcare Provider Details

I. General information

NPI: 1427180793
Provider Name (Legal Business Name): NELSON CHIROPRACTIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 THOUSAND OAKS DR STE 102
SAN ANTONIO TX
78232-4108
US

IV. Provider business mailing address

2828 THOUSAND OAKS DR STE 102
SAN ANTONIO TX
78232-4108
US

V. Phone/Fax

Practice location:
  • Phone: 210-348-6377
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number6376
License Number StateTX

VIII. Authorized Official

Name: DR. GREGORY W NELSON
Title or Position: PRESIDENT
Credential: DC
Phone: 210-348-6377