Provider Demographics
NPI:1881678845
Name:MICHAEL, JOSEPH CRAIG (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CRAIG
Last Name:MICHAEL
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 1:900A PAT BOOKER RD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSAL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78148-4132
Mailing Address - Country:US
Mailing Address - Phone:210-653-8045
Mailing Address - Fax:210-653-8050
Practice Address - Street 1:900A PAT BOOKER RD
Practice Address - Street 2:
Practice Address - City:UNIVERSAL CITY
Practice Address - State:TX
Practice Address - Zip Code:78148-4132
Practice Address - Country:US
Practice Address - Phone:210-653-8045
Practice Address - Fax:210-653-8050
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-02
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9571111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX606691OtherBLUE CROSS BLUE SHEILD
TXU85830Medicare UPIN
TX611715Medicare ID - Type Unspecified