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General NPI Number Information
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NPI Number | 1316128838
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Entity Type | Organization
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Legal Business Name | BETTIOL FAMILY ENTERPRISES, LP
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Dates
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Enumeration Date | 11/27/2007
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Last Update Date | 11/21/2011
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Provider Practice Location Address
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Address Line | 2151 HARVEY MITCHELL PKWY S SUITE 112
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City | COLLEGE STATION
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State | TX
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Zip | 77840-5281
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Country | US
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Telephone | 979-764-3100
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Fax | 979-764-3144
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Provider Business Mailing Address
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Address Line | 2151 HARVEY MITCHELL PKWY S SUITE 112
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City | COLLEGE STATION
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State | TX
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Zip | 77840-5281
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Country | US
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Telephone | 979-764-3100
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Fax | 979-764-3144
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. SHEILA S BETTIOL
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Credential |
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Telephone | 979-764-3100
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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 | 9875
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License Number State | TX
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