Provider Demographics
NPI:1790894582
Name:ALFIERI, ANTONIO III (DC)
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:
Last Name:ALFIERI
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5815 W WILLIAM CANNON DR STE 101
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-1966
Mailing Address - Country:US
Mailing Address - Phone:512-301-5996
Mailing Address - Fax:512-301-5692
Practice Address - Street 1:5815 W WILLIAM CANNON DR STE 101
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749
Practice Address - Country:US
Practice Address - Phone:512-301-5996
Practice Address - Fax:512-301-5692
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAA007538111N00000X
TX13833111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4344547Medicaid
MI4344547Medicaid