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General NPI Number Information
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NPI Number | 1205958311
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Entity Type | Organization
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Legal Business Name | FABRY FAMILY CHIROPRACTIC PC
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 02/26/2009
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Provider Practice Location Address
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Address Line | 505 E PALM VALLEY BLVD SUITE 240
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City | ROUND ROCK
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State | TX
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Zip | 78664-3041
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Country | US
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Telephone | 512-310-7177
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Fax | 512-246-0045
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Provider Business Mailing Address
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Address Line | 505 E PALM VALLEY BLVD SUITE 240
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City | ROUND ROCK
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State | TX
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Zip | 78664-3041
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Country | US
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Telephone | 512-310-7177
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Fax | 512-246-0045
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEREMIAH D FABRY
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Credential | DC
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Telephone | 512-310-7177
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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 |
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License Number State | TX
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