Provider Demographics
NPI:1417232232
Name:CORPUS CHRISTI CHIROPRACTIC ASSOCIATES INC.
Entity Type:Organization
Organization Name:CORPUS CHRISTI CHIROPRACTIC ASSOCIATES INC.
Other - Org Name:DR. CHARLES A. VOTZMEYER JR. DC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:VOTZMEYER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:361-992-1851
Mailing Address - Street 1:5826 ESPLANADE DR STE 302
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4208
Mailing Address - Country:US
Mailing Address - Phone:361-992-1851
Mailing Address - Fax:361-992-2367
Practice Address - Street 1:5826 ESPLANADE DR STE 302
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4208
Practice Address - Country:US
Practice Address - Phone:361-992-1851
Practice Address - Fax:361-992-2367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2704261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX600958Medicare PIN