MEDICARE: NIKOLAS CHASE BIXENMAN 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	111N00000X	Chiropractor	13855	TX

General Provider Information

NPI Number	:	1932694056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIKOLAS CHASE BIXENMAN DC

Provider Business Mailing Address
First Line	:	1906 2ND AVE
Second Line	:
City	:	CANYON
State	:	TX
Zip	:	79015-3008
Country	:	US
Telephone Number	:	806-367-8719
Fax Number	:	806-418-4329

Provider Business Practice Location Address
First Line	:	3501 S SONCY RD STE 1001
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79119-4932
Country	:	US
Telephone Number	:	806-367-8719
Fax Number	:	806-418-4329

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

Provider Enumeration Date	:	07/01/2018
Last Update Date	:	11/09/2020

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Directions to “ NIKOLAS CHASE BIXENMAN DC” Practice Location

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