MEDICARE: DR. GOLAB'S CHIROPRACTIC & WELLNESS PA

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	7943	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00281W	OTHER	TX	MEDICARE GROUP

General Provider Information

NPI Number	:	1831210921
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. GOLAB'S CHIROPRACTIC & WELLNESS PA

Provider Business Mailing Address
First Line	:	1205 N LOOP 1604 W
Second Line	:	SUITE 211
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4624
Country	:	US
Telephone Number	:	210-764-8888
Fax Number	:	830-460-9329

Provider Business Practice Location Address
First Line	:	1205 N LOOP 1604 W
Second Line	:	SUITE 211
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4624
Country	:	US
Telephone Number	:	210-764-8888
Fax Number	:	210-764-2601

Authorized Official
Title or Position	:	OWNER
Name	:	MICHAEL ROBERT GOLAB
Credential	:
Telephone Number	:	210-764-8888

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	03/01/2019

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Directions to “DR. GOLAB'S CHIROPRACTIC & WELLNESS PA ” Practice Location

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