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General NPI Number Information
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NPI Number | 1376673079
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Entity Type | Organization
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Legal Business Name | AUSTIN CHIROPRACTIC CENTER, P.C.
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6800 W GATE BLVD SUITE 117
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City | AUSTIN
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State | TX
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Zip | 78745-4883
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Country | US
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Telephone | 512-445-3366
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Fax |
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Provider Business Mailing Address
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Address Line | 6800 W GATE BLVD SUITE 117
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City | AUSTIN
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State | TX
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Zip | 78745-4883
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CORPORATE PRESIDENT & TREASURER
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Name | DR. CYNTHIA VAUGHN
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Credential |
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Telephone | 512-445-3366
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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 | 4933
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License Number State | TX
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