Provider Demographics
NPI:1750327656
Name:KANZ, KEVIN DARROW (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:DARROW
Last Name:KANZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:UNIVERSITY
Other - Middle Name:CHIROPRACTIC
Other - Last Name:CENTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1111 W 24TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-4654
Mailing Address - Country:US
Mailing Address - Phone:512-480-8889
Mailing Address - Fax:512-480-8899
Practice Address - Street 1:1111 W 24TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-4654
Practice Address - Country:US
Practice Address - Phone:512-480-8889
Practice Address - Fax:512-480-8899
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5046111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT81932Medicare UPIN