Provider Demographics
NPI:1518667484
Name:CONCIERGE ORTHOPEDICS
Entity Type:Organization
Organization Name:CONCIERGE ORTHOPEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:870-723-5068
Mailing Address - Street 1:459 STONE VIEW TRL
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78737-2849
Mailing Address - Country:US
Mailing Address - Phone:870-723-5068
Mailing Address - Fax:
Practice Address - Street 1:459 STONE VIEW TRL
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78737-2849
Practice Address - Country:US
Practice Address - Phone:870-723-5068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy