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General NPI Number Information
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NPI Number | 1699024752
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Entity Type | Organization
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Legal Business Name | MAULDIN HEINRICH CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 09/05/2012
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Last Update Date | 09/05/2012
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Provider Practice Location Address
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Address Line | 4131 SPICEWOOD SPRINGS RD STE O1
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City | AUSTIN
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State | TX
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Zip | 78759-8664
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Country | US
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Telephone | 512-795-0707
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Fax | 512-795-7742
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Provider Business Mailing Address
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Address Line | 4131 SPICEWOOD SPRINGS RD STE O1
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City | AUSTIN
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State | TX
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Zip | 78759-8664
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Country | US
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Telephone | 512-795-0707
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Fax | 512-795-7742
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | SYLVIA MAULDIN MCMINN
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Credential |
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Telephone | 512-795-0707
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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 | DC 5085
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License Number State | TX
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