Provider Demographics
NPI:1871637793
Name:STURGEON, JEFFREY S (DC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:S
Last Name:STURGEON
Suffix:
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 1:1731 FRESNO
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-3522
Mailing Address - Country:US
Mailing Address - Phone:210-734-4667
Mailing Address - Fax:
Practice Address - Street 1:1518 AUSTIN HWY
Practice Address - Street 2:SUITE NUMBER 13
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-6048
Practice Address - Country:US
Practice Address - Phone:210-824-9595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5721111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor