Provider Demographics
NPI:1003839929
Name:ALBRACHT, NICK G (DC)
Entity Type:Individual
Prefix:DR
First Name:NICK
Middle Name:G
Last Name:ALBRACHT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-4574
Mailing Address - Country:US
Mailing Address - Phone:817-295-6176
Mailing Address - Fax:817-295-6177
Practice Address - Street 1:281 MARKET ST
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-4574
Practice Address - Country:US
Practice Address - Phone:817-295-6176
Practice Address - Fax:817-295-6177
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC 5209111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX605883OtherBCBS PROVIDER #
TXU72496Medicare UPIN
TX609164Medicare ID - Type UnspecifiedCHIROPRACTIC PROVIDER #