Provider Demographics
NPI:1497955181
Name:VICTORIA CHIROPRACTIC CLINIC PLLC
Entity Type:Organization
Organization Name:VICTORIA CHIROPRACTIC CLINIC PLLC
Other - Org Name:VICTORIA CHIROPRACTIC CLINIC PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LONNIE
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:FRANKA
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:361-578-9966
Mailing Address - Street 1:2004 PATTERSON DR
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-5645
Mailing Address - Country:US
Mailing Address - Phone:361-578-9966
Mailing Address - Fax:361-578-9997
Practice Address - Street 1:2004 PATTERSON DR
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-5645
Practice Address - Country:US
Practice Address - Phone:361-578-9966
Practice Address - Fax:361-578-9997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9159DC111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXOO18NEOtherBLUE CROSS/BLUE SHIELD GR
OOW236OtherMEDICARE GROUP
TXU92760OtherUPIN
TX8F2466OtherBLUE CROSS/BLUE SHIELD IN
182380901OtherMEDICAID INDIVIDUAL
TX1823791-01Medicaid