Provider Demographics
NPI:1649387069
Name:ROBERT EHLE, D.C., P.A.
Entity Type:Organization
Organization Name:ROBERT EHLE, D.C., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:EHLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:806-355-5800
Mailing Address - Street 1:2213 W INTERSTATE 40
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-1849
Mailing Address - Country:US
Mailing Address - Phone:806-355-5800
Mailing Address - Fax:806-355-1400
Practice Address - Street 1:2213 W INTERSTATE 40
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-1849
Practice Address - Country:US
Practice Address - Phone:806-355-5800
Practice Address - Fax:806-355-1400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1676256-01Medicaid
TX00261WMedicare ID - Type UnspecifiedGROUP NUMBER