Healthcare Provider Details

I. General information

NPI: 1649185794
Provider Name (Legal Business Name): NUEVA VIDA CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 FENWICK DR
WINDCREST TX
78239-2532
US

IV. Provider business mailing address

513 FENWICK DR
WINDCREST TX
78239-2532
US

V. Phone/Fax

Practice location:
  • Phone: 210-387-5359
  • Fax:
Mailing address:
  • Phone: 210-387-5359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: MARINA DE LA GARZA
Title or Position: CHIROPRACTOR/OWNER
Credential: DC
Phone: 210-387-5359