Provider Demographics
NPI:1740793447
Name:ANA BUMSTEAD DC PLLC
Entity Type:Organization
Organization Name:ANA BUMSTEAD DC PLLC
Other - Org Name:ABC FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUMSTEAD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:409-227-0282
Mailing Address - Street 1:815 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:TX
Mailing Address - Zip Code:77657-7358
Mailing Address - Country:US
Mailing Address - Phone:409-227-0282
Mailing Address - Fax:
Practice Address - Street 1:815 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:TX
Practice Address - Zip Code:77657-7358
Practice Address - Country:US
Practice Address - Phone:409-227-0282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-16
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13346111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty