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General NPI Number Information
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NPI Number | 1912312927
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Entity Type | Organization
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Legal Business Name | KING CHIROPRACTIC AND WELLNESS PLLC
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Dates
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Enumeration Date | 06/27/2014
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Last Update Date | 11/19/2018
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Provider Practice Location Address
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Address Line | 8705 SHOAL CREEK BLVD STE 101
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City | AUSTIN
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State | TX
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Zip | 78757-6839
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Country | US
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Telephone | 512-243-6413
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Fax | 512-717-0284
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Provider Business Mailing Address
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Address Line | 7756 NORTHCROSS DR SUITE 203
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City | AUSTIN
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State | TX
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Zip | 78757-1735
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Country | US
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Telephone | 512-910-7005
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Fax |
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | ALBERTO KING
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Credential | DC
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Telephone | 512-243-6413
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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 | 12250
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License Number State | TX
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