MEDICARE: JUAN DANIEL BAZAN D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	11694	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11694	OTHER	TX	CHIROPRACTIC LICENSE

General Provider Information

NPI Number	:	1154612984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUAN DANIEL BAZAN D.C.

Provider Business Mailing Address
First Line	:	PO BOX 700688
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78270-0688
Country	:	US
Telephone Number	:	210-318-3007
Fax Number	:	210-468-0682

Provider Business Practice Location Address
First Line	:	66 GRUENE PARK DR STE 109
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-2219
Country	:	US
Telephone Number	:	210-318-3007
Fax Number	:	210-468-0682

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2011
Last Update Date	:	02/24/2026

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Directions to “ JUAN DANIEL BAZAN D.C.” Practice Location

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