Provider Demographics
NPI:1164594701
Name:BORHO, ROYCE (DC)
Entity Type:Individual
Prefix:DR
First Name:ROYCE
Middle Name:
Last Name:BORHO
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 1:7612 W HIGHWAY 71 STE C
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-8248
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7612 W HIGHWAY 71 STE C
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-8248
Practice Address - Country:US
Practice Address - Phone:512-301-9191
Practice Address - Fax:512-301-9192
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2408111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX600753Medicare ID - Type Unspecified