=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245783455
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DR. JOSEPH C MICHAEL D.C. PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/25/2016
-----------------------------------------------------
Last Update Date | 07/25/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 900A PAT BOOKER RD
-----------------------------------------------------
City | UNIVERSAL CITY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78148-4132
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-653-8045
-----------------------------------------------------
Fax | 210-653-8050
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 900A PAT BOOKER RD
-----------------------------------------------------
City | UNIVERSAL CITY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78148-4132
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-653-8045
-----------------------------------------------------
Fax | 210-653-8050
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. JOSEPH MICHAEL
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 210-653-8045
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111NN1001X
-----------------------------------------------------
Taxonomy Name | Nutrition Chiropractor
-----------------------------------------------------
License Number | 09571
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 09571
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------