Provider Demographics
NPI:1730638909
Name:ERDMANN, NEBILE ALYCE (DC)
Entity Type:Individual
Prefix:DR
First Name:NEBILE
Middle Name:ALYCE
Last Name:ERDMANN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 WINSCOTT RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:BENBROOK
Mailing Address - State:TX
Mailing Address - Zip Code:76126-2778
Mailing Address - Country:US
Mailing Address - Phone:817-249-8888
Mailing Address - Fax:
Practice Address - Street 1:1008 WINSCOTT RD
Practice Address - Street 2:SUITE A
Practice Address - City:BENBROOK
Practice Address - State:TX
Practice Address - Zip Code:76126-2778
Practice Address - Country:US
Practice Address - Phone:817-249-8888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-28
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13317111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor