Provider Demographics
NPI:1386829836
Name:SOUTHWEST CHIROPRACTIC CLINIC P C
Entity Type:Organization
Organization Name:SOUTHWEST CHIROPRACTIC CLINIC P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:PRESTON
Authorized Official - Last Name:CHRISTIE
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:210-924-2225
Mailing Address - Street 1:6500 S FLORES ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78214-2628
Mailing Address - Country:US
Mailing Address - Phone:210-924-2225
Mailing Address - Fax:210-924-2225
Practice Address - Street 1:6500 S FLORES ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78214-2628
Practice Address - Country:US
Practice Address - Phone:210-924-2225
Practice Address - Fax:210-924-2225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0883621-02Medicaid