Provider Demographics
NPI:1669661096
Name:COLE CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:COLE CHIROPRACTIC, P.C.
Other - Org Name:WOODS CHIROPRACTIC AND WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:BRYAN
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-442-9595
Mailing Address - Street 1:2501 W WILLIAM CANNON DR
Mailing Address - Street 2:208
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-5281
Mailing Address - Country:US
Mailing Address - Phone:512-442-9595
Mailing Address - Fax:512-441-5111
Practice Address - Street 1:2501 W WILLIAM CANNON DR
Practice Address - Street 2:208
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5281
Practice Address - Country:US
Practice Address - Phone:512-442-9595
Practice Address - Fax:512-441-5111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6926111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX609180Medicare UPIN