Provider Demographics
NPI:1558702126
Name:HUNEYCUTT CHIROPRACTIC PC
Entity Type:Organization
Organization Name:HUNEYCUTT CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:HUNEYCUTT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-255-5846
Mailing Address - Street 1:1106 S. MAYS ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-6746
Mailing Address - Country:US
Mailing Address - Phone:512-255-5846
Mailing Address - Fax:
Practice Address - Street 1:1106 S. MAYS ST
Practice Address - Street 2:SUITE 210
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-6746
Practice Address - Country:US
Practice Address - Phone:512-255-5846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2726111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX601015Medicare UPIN