Provider Demographics
NPI:1326069444
Name:BOMBEN, ROSS MATTHEW (DC)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:MATTHEW
Last Name:BOMBEN
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 1:2714 BEE CAVE RD
Mailing Address - Street 2:SUITE #100
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5677
Mailing Address - Country:US
Mailing Address - Phone:512-587-4263
Mailing Address - Fax:512-330-9975
Practice Address - Street 1:2714 BEE CAVE RD
Practice Address - Street 2:SUITE #100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5677
Practice Address - Country:US
Practice Address - Phone:512-587-4263
Practice Address - Fax:512-330-9975
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10330111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor