Provider Demographics
NPI:1144242074
Name:SCHTUPAK, BRIAN STEVEN (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:STEVEN
Last Name:SCHTUPAK
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 1:16932 CRYSTAL LN
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-2319
Mailing Address - Country:US
Mailing Address - Phone:956-821-0181
Mailing Address - Fax:
Practice Address - Street 1:630 MANZANO ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-6359
Practice Address - Country:US
Practice Address - Phone:505-344-7246
Practice Address - Fax:505-344-2666
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10433111N00000X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician