Provider Demographics
NPI:1093287732
Name:SEASIDE CHIROPRACTIC, PA
Entity Type:Organization
Organization Name:SEASIDE CHIROPRACTIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULZE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:361-855-0000
Mailing Address - Street 1:1518 AUSTIN HWY STE 13
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-6047
Mailing Address - Country:US
Mailing Address - Phone:210-824-9595
Mailing Address - Fax:210-826-8588
Practice Address - Street 1:6418 S STAPLES ST STE 142
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-2938
Practice Address - Country:US
Practice Address - Phone:361-855-0000
Practice Address - Fax:361-882-9944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty