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General NPI Number Information
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NPI Number | 1164052825
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Entity Type | Individual
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Provider Name | CHASE A DAVIDSON DC, CSCS
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Gender | Male
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Dates
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Enumeration Date | 01/22/2020
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Last Update Date | 07/30/2021
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Provider Practice Location Address
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Address Line | 208 W POWELL LN
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City | AUSTIN
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State | TX
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Zip | 78753-5931
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Country | US
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Telephone | 512-686-6611
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Fax |
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Provider Business Mailing Address
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Address Line | 3816 S LAMAR BLVD APT 2712
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City | AUSTIN
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State | TX
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Zip | 78704-7955
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Country | US
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Telephone | 253-241-7803
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Fax |
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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 | CHR.0008161
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License Number State | CO
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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 | 14470
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License Number State | TX
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