Provider Demographics
NPI:1114925096
Name:TRIPPE, KEVIN L (DC)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:L
Last Name:TRIPPE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7410 BLANCO RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-4363
Mailing Address - Country:US
Mailing Address - Phone:800-404-6050
Mailing Address - Fax:
Practice Address - Street 1:2700 W PECAN ST
Practice Address - Street 2:SUITE 750
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-3199
Practice Address - Country:US
Practice Address - Phone:800-404-6050
Practice Address - Fax:866-298-4032
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9299111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXV00343Medicare UPIN
TX610755Medicare ID - Type Unspecified