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General NPI Number Information
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NPI Number | 1982300315
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Entity Type | Organization
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Legal Business Name | TWIN LAKES FAMILY CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 02/07/2023
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Last Update Date | 05/02/2023
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Provider Practice Location Address
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Address Line | 12314 N INTERSTATE 35 STE 108
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City | AUSTIN
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State | TX
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Zip | 78753-1349
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Country | US
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Telephone | 512-717-6597
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Fax |
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Provider Business Mailing Address
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Address Line | 12314 N INTERSTATE 35 STE 108
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City | AUSTIN
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State | TX
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Zip | 78753-1349
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Country | US
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Telephone | 512-717-6597
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Fax |
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Authorized Official
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Title or Position | PROVIDER/OWNER/AO
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Name | DR. SARA RICHA
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Credential | DC
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Telephone | 703-434-2947
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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 |
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License Number State |
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