Provider Demographics
NPI:1114178555
Name:ACE CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:ACE CHIROPRACTIC PLLC
Other - Org Name:ACE CHIROPRACTIC & ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BYOUNG
Authorized Official - Middle Name:CHAN
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DC LAC
Authorized Official - Phone:512-339-1888
Mailing Address - Street 1:13740 N HIGHWAY 183 STE G3
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-1821
Mailing Address - Country:US
Mailing Address - Phone:512-339-1888
Mailing Address - Fax:512-339-1889
Practice Address - Street 1:13740 N HIGHWAY 183
Practice Address - Street 2:STE G4
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750
Practice Address - Country:US
Practice Address - Phone:512-339-1888
Practice Address - Fax:512-339-1889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-03
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10937111N00000X
TXAC01614171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0A3569Medicare PIN