Provider Demographics
NPI:1679020515
Name:EBERLE, JON (DC)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:
Last Name:EBERLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13062 US-290
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78737-8811
Mailing Address - Country:US
Mailing Address - Phone:512-362-8865
Mailing Address - Fax:888-660-3135
Practice Address - Street 1:13062 US 290 W
Practice Address - Street 2:SUITE 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78737
Practice Address - Country:US
Practice Address - Phone:512-362-8865
Practice Address - Fax:888-660-3135
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-08
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13264111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor