Provider Demographics
NPI:1366670853
Name:NEIGERT, DOREA WILDER (DC)
Entity Type:Individual
Prefix:DR
First Name:DOREA
Middle Name:WILDER
Last Name:NEIGERT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:DOREA
Other - Middle Name:LEIGH
Other - Last Name:WILDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1705 S CAPITAL OF TEXAS HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6551
Mailing Address - Country:US
Mailing Address - Phone:512-567-6343
Mailing Address - Fax:833-807-0121
Practice Address - Street 1:1705 S CAPITAL OF TEXAS HWY STE 300
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6551
Practice Address - Country:US
Practice Address - Phone:512-567-6343
Practice Address - Fax:833-807-0121
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5200111NS0005X
TX11777111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX11777OtherTEXAS LICENSE