MEDICARE: DR. JULIO C REGALADO DC

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	111NX0800X	Orthopedic Chiropractor	9197	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9197	OTHER	TX	LIC

General Provider Information

NPI Number	:	1235140906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIO C REGALADO DC

Provider Business Mailing Address
First Line	:	96 CROSSROADS BLVD STE 250
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78201-6523
Country	:	US
Telephone Number	:	210-733-9090
Fax Number	:	210-733-9093

Provider Business Practice Location Address
First Line	:	96 CROSSROADS BLVD STE 250
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78201-6523
Country	:	US
Telephone Number	:	210-733-9090
Fax Number	:	210-733-9093

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

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. JULIO C REGALADO DC” Practice Location

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