Provider Demographics
NPI:1710014014
Name:CAPITOL OF TEXAS CHIROPRACTIC CENTER, INC.
Entity Type:Organization
Organization Name:CAPITOL OF TEXAS CHIROPRACTIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-326-1400
Mailing Address - Street 1:5625 EIGER RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-8976
Mailing Address - Country:US
Mailing Address - Phone:512-326-1400
Mailing Address - Fax:512-326-1463
Practice Address - Street 1:5625 EIGER RD
Practice Address - Street 2:SUITE 160
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-8976
Practice Address - Country:US
Practice Address - Phone:512-326-1400
Practice Address - Fax:512-326-1463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC6885261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0066KUOtherBCBS PROVIDER NUMBER