Provider Demographics
NPI:1831311927
Name:FOUR POINTS FAMILY CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:FOUR POINTS FAMILY CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:COCCIMIGLIO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-345-9355
Mailing Address - Street 1:10815 FM 2222
Mailing Address - Street 2:3C-100
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78730
Mailing Address - Country:US
Mailing Address - Phone:512-345-9355
Mailing Address - Fax:512-345-9357
Practice Address - Street 1:10815 FM 2222
Practice Address - Street 2:3C-100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78730
Practice Address - Country:US
Practice Address - Phone:512-345-9355
Practice Address - Fax:512-345-9357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10368111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty