Provider Demographics
NPI:1275156119
Name:ACOSTA, AUSTIN RAUL (DC)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:RAUL
Last Name:ACOSTA
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 1:2225 E RANDOL MILL RD STE 519
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-6308
Mailing Address - Country:US
Mailing Address - Phone:682-252-4168
Mailing Address - Fax:
Practice Address - Street 1:2225 E RANDOL MILL RD STE 519
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-6308
Practice Address - Country:US
Practice Address - Phone:682-252-4168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14333111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX14333OtherSTATE LICENSE