Provider Demographics
NPI:1932100336
Name:NORTH LAMAR CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:NORTH LAMAR CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:H
Authorized Official - Last Name:LONES
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:512-835-1955
Mailing Address - Street 1:10102 N LAMAR BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-3602
Mailing Address - Country:US
Mailing Address - Phone:812-835-1955
Mailing Address - Fax:512-835-4424
Practice Address - Street 1:10102 N LAMAR BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-3602
Practice Address - Country:US
Practice Address - Phone:812-835-1955
Practice Address - Fax:512-835-4424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4013111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX601556OtherBCBS
TX601556OtherBCBS
TX601556Medicare ID - Type Unspecified