Provider Demographics
NPI:1427233139
Name:MATT PARSONS CHIROPRACTIC ASSOCIATES, INC.
Entity Type:Organization
Organization Name:MATT PARSONS CHIROPRACTIC ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-321-9604
Mailing Address - Street 1:1009 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:TX
Mailing Address - Zip Code:78602-3303
Mailing Address - Country:US
Mailing Address - Phone:512-321-9604
Mailing Address - Fax:512-581-9600
Practice Address - Street 1:1009 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-3303
Practice Address - Country:US
Practice Address - Phone:512-321-9604
Practice Address - Fax:512-581-9600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9845111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
V03090Medicare UPIN