Provider Demographics
NPI:1376673079
Name:AUSTIN CHIROPRACTIC CENTER, P.C.
Entity Type:Organization
Organization Name:AUSTIN CHIROPRACTIC CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE PRESIDENT & TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-445-3366
Mailing Address - Street 1:6800 W GATE BLVD
Mailing Address - Street 2:SUITE 117
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-4883
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6800 W GATE BLVD
Practice Address - Street 2:SUITE 117
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-4883
Practice Address - Country:US
Practice Address - Phone:512-445-3366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4933111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00000025CPOtherBC & BS GROUP NUMBER
TX00000025CPOtherBC & BS GROUP NUMBER