=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699920140
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DR. DANI TALAMANTEZ
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/25/2008
-----------------------------------------------------
Last Update Date | 11/25/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2114A N 10TH ST
-----------------------------------------------------
City | MCALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78501-4155
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-682-8300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2114A N 10TH ST
-----------------------------------------------------
City | MCALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78501-4155
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-682-8300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111NR0400X
-----------------------------------------------------
Taxonomy Name | Rehabilitation Chiropractor
-----------------------------------------------------
License Number | DC7253
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------