Provider Demographics
NPI:1932282522
Name:ZYGMONT, GREG D (DC)
Entity Type:Individual
Prefix:
First Name:GREG
Middle Name:D
Last Name:ZYGMONT
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 1:5900 SLAUGHTER LN W
Mailing Address - Street 2:SUITE #470
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-6511
Mailing Address - Country:US
Mailing Address - Phone:512-288-5502
Mailing Address - Fax:512-288-6529
Practice Address - Street 1:5900 SLAUGHTER LN W
Practice Address - Street 2:SUITE #470
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-6511
Practice Address - Country:US
Practice Address - Phone:512-288-5502
Practice Address - Fax:512-288-6529
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8017111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor