Provider Demographics
NPI:1255465969
Name:SOUTH TEXAS CLINIC OF CHIROPRACTIC
Entity Type:Organization
Organization Name:SOUTH TEXAS CLINIC OF CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:R
Authorized Official - Last Name:GUERRA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:956-682-1832
Mailing Address - Street 1:2522 BUDDY OWENS AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-5464
Mailing Address - Country:US
Mailing Address - Phone:956-682-1832
Mailing Address - Fax:956-682-1829
Practice Address - Street 1:2522 BUDDY OWENS AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-5464
Practice Address - Country:US
Practice Address - Phone:956-682-1832
Practice Address - Fax:956-682-1829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10027111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXV07397Medicare UPIN
TX00834ZMedicare PIN