Provider Demographics
NPI:1053481234
Name:JAY A WORKMAN CHIROPRACTIC ASSOCIATES PC
Entity Type:Organization
Organization Name:JAY A WORKMAN CHIROPRACTIC ASSOCIATES PC
Other - Org Name:LIVINGSTON CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:WORKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:936-327-3140
Mailing Address - Street 1:400 BYPASS LN
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-6351
Mailing Address - Country:US
Mailing Address - Phone:936-327-3140
Mailing Address - Fax:
Practice Address - Street 1:400 BYPASS LN
Practice Address - Street 2:SUITE 103
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-6351
Practice Address - Country:US
Practice Address - Phone:936-327-3140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11759111N00000X
TX4311111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB128123Medicare PIN