=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942570148
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CAREPLUS CHIROPRACTIC, P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/04/2012
-----------------------------------------------------
Last Update Date | 01/04/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12129 FM 620 N SUITE 430
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78750-1090
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-250-0025
-----------------------------------------------------
Fax | 512-250-0050
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12129 FM 620 N SUITE 430
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78750-1090
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-250-0025
-----------------------------------------------------
Fax | 512-250-0050
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR OF CHIROPRACTIC/OWNER
-----------------------------------------------------
Name | DR. DAPHNE DAWN SAVEDRA
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 512-689-2331
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 10232
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------