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General NPI Number Information
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NPI Number | 1104937028
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Entity Type | Individual
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Provider Name | DOUGLAS STAKES D.C.
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 07/21/2021
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Provider Practice Location Address
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Address Line | 7413 OLD BEE CAVES RD
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City | AUSTIN
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State | TX
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Zip | 78735-8234
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Country | US
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Telephone | 512-892-2160
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Fax | 512-892-7309
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Provider Business Mailing Address
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Address Line | 9609 STREAMSIDE DR
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City | AUSTIN
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State | TX
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Zip | 78736-2411
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Country | US
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Telephone | 512-892-2160
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Fax | 512-892-7309
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 483
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2312
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2943
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License Number State | TX
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