Provider Demographics
NPI:1689809352
Name:LOVEROUS WHITTAKER, II, D.C.
Entity Type:Organization
Organization Name:LOVEROUS WHITTAKER, II, D.C.
Other - Org Name:AUSTIN FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LOVEROUS
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITTAKER
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:512-692-4737
Mailing Address - Street 1:9001 ANNA ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-1625
Mailing Address - Country:US
Mailing Address - Phone:512-692-4737
Mailing Address - Fax:
Practice Address - Street 1:9001 ANNA ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-1625
Practice Address - Country:US
Practice Address - Phone:512-692-4737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-24
Last Update Date:2009-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9384111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1659426245OtherTYPE 1 NPI