Provider Demographics
NPI:1629398078
Name:MICHAEL R. BANDY DC
Entity Type:Organization
Organization Name:MICHAEL R. BANDY DC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:BANDY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-467-0370
Mailing Address - Street 1:2700 W ANDERSON LN
Mailing Address - Street 2:SUITE # 512
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-1159
Mailing Address - Country:US
Mailing Address - Phone:512-467-0370
Mailing Address - Fax:512-454-8846
Practice Address - Street 1:2700 W ANDERSON LN
Practice Address - Street 2:SUITE # 512
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-1159
Practice Address - Country:US
Practice Address - Phone:512-467-0370
Practice Address - Fax:512-454-8846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-08
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6519111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty