Provider Demographics
NPI:1932694056
Name:BIXENMAN, NIKOLAS CHASE (DC)
Entity Type:Individual
Prefix:
First Name:NIKOLAS
Middle Name:CHASE
Last Name:BIXENMAN
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 1:1906 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:79015-3008
Mailing Address - Country:US
Mailing Address - Phone:806-367-8719
Mailing Address - Fax:806-418-4329
Practice Address - Street 1:3501 S SONCY RD STE 1001
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-4932
Practice Address - Country:US
Practice Address - Phone:806-367-8719
Practice Address - Fax:806-418-4329
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-01
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13855111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor