Provider Demographics
NPI:1083890826
Name:RICHARD FAMILY CHIROPRACTIC, PA
Entity Type:Organization
Organization Name:RICHARD FAMILY CHIROPRACTIC, PA
Other - Org Name:GONSTEAD CHIROPRACTIC & WELLNESS ATX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AL
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:RICHARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-542-9031
Mailing Address - Street 1:3006 BEE CAVES RD STE A300
Mailing Address - Street 2:
Mailing Address - City:ROLLINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5541
Mailing Address - Country:US
Mailing Address - Phone:512-542-9031
Mailing Address - Fax:512-478-1752
Practice Address - Street 1:3006 BEE CAVES RD STE A300
Practice Address - Street 2:
Practice Address - City:ROLLINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:78746-5541
Practice Address - Country:US
Practice Address - Phone:512-542-9031
Practice Address - Fax:512-478-1752
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RICHARD FAMILY CHIROPRACTIC, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-10
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8U8720OtherBLUE CROSS BLUE SHIELD
TX8U8720OtherBLUE CROSS BLUE SHIELD