Provider Demographics
NPI:1851647408
Name:AUSTIN CHIROPRACTIC AND WELLNESS LTD LLP
Entity Type:Organization
Organization Name:AUSTIN CHIROPRACTIC AND WELLNESS LTD LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TREVOR
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BOTTS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-257-3627
Mailing Address - Street 1:13740 N HIGHWAY 183
Mailing Address - Street 2:STE L4
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-1884
Mailing Address - Country:US
Mailing Address - Phone:512-257-3627
Mailing Address - Fax:512-257-9870
Practice Address - Street 1:13740 N HIGHWAY 183
Practice Address - Street 2:STE L4
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1884
Practice Address - Country:US
Practice Address - Phone:512-257-3627
Practice Address - Fax:512-257-9870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11922111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty