Provider Demographics
NPI:1083888259
Name:NEWBERN, KARLY KAYE (DC)
Entity Type:Individual
Prefix:DR
First Name:KARLY
Middle Name:KAYE
Last Name:NEWBERN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 UNIVERSITY DR
Mailing Address - Street 2:SUITE 803
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77840-1353
Mailing Address - Country:US
Mailing Address - Phone:214-477-9867
Mailing Address - Fax:
Practice Address - Street 1:505 UNIVERSITY DR
Practice Address - Street 2:SUITE 803
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77840-1353
Practice Address - Country:US
Practice Address - Phone:214-477-9867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10699111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor