Provider Demographics
NPI:1558348797
Name:SHIGLEY, DIANE ELIZABETH (DC)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:ELIZABETH
Last Name:SHIGLEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13552 N HWY 183
Mailing Address - Street 2:STE D
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-2272
Mailing Address - Country:US
Mailing Address - Phone:512-331-3833
Mailing Address - Fax:512-331-4507
Practice Address - Street 1:13552 N HWY 183
Practice Address - Street 2:STE D
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-2272
Practice Address - Country:US
Practice Address - Phone:512-331-3833
Practice Address - Fax:512-331-4507
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6011111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDC6011OtherSTATE LICENSE NUMBER