Provider Demographics
NPI:1235259334
Name:ACCIDENT & PAIN CHIROPRACTIC CLINIC, INC.
Entity Type:Organization
Organization Name:ACCIDENT & PAIN CHIROPRACTIC CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:AMES
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:210-599-7246
Mailing Address - Street 1:113 CINNABAR TRL
Mailing Address - Street 2:
Mailing Address - City:CIBOLO
Mailing Address - State:TX
Mailing Address - Zip Code:78108-4238
Mailing Address - Country:US
Mailing Address - Phone:210-599-7246
Mailing Address - Fax:
Practice Address - Street 1:800 ROY RICHARD DR
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-1028
Practice Address - Country:US
Practice Address - Phone:210-599-7246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4486111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00871ZMedicare ID - Type UnspecifiedMEDICARE GROUP NUMBER