Provider Demographics
NPI:1235140906
Name:REGALADO, JULIO C (DC)
Entity Type:Individual
Prefix:DR
First Name:JULIO
Middle Name:C
Last Name:REGALADO
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 1:96 CROSSROADS BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-6523
Mailing Address - Country:US
Mailing Address - Phone:210-733-9090
Mailing Address - Fax:210-733-9093
Practice Address - Street 1:96 CROSSROADS BLVD STE 250
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-6523
Practice Address - Country:US
Practice Address - Phone:210-733-9090
Practice Address - Fax:210-733-9093
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9197111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX9197OtherLIC