Provider Demographics
NPI:1689680704
Name:GOEBEL, MICHAEL L (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:L
Last Name:GOEBEL
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 1:1404 CLAREWOOD DR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-8417
Mailing Address - Country:US
Mailing Address - Phone:512-878-1195
Mailing Address - Fax:512-878-8526
Practice Address - Street 1:1404 CLAREWOOD DR.
Practice Address - Street 2:SUITE 107
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-6864
Practice Address - Country:US
Practice Address - Phone:512-557-1195
Practice Address - Fax:512-878-8526
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME609468Medicare ID - Type UnspecifiedMEDICARE