Provider Demographics
NPI:1144390444
Name:TINSLEY, ALICIA D (DC)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:D
Last Name:TINSLEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1048 E BLANCO RD
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-1800
Mailing Address - Country:US
Mailing Address - Phone:830-816-2866
Mailing Address - Fax:830-249-9529
Practice Address - Street 1:1048 E BLANCO RD
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-1800
Practice Address - Country:US
Practice Address - Phone:830-816-2866
Practice Address - Fax:830-249-9529
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6791111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX605320OtherBCBS
TX605320Medicare PIN
TX58961Medicare UPIN