Provider Demographics
NPI:1942210935
Name:ECHOLS, JEFFREY KIRK (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:KIRK
Last Name:ECHOLS
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 1:3809 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-7036
Mailing Address - Country:US
Mailing Address - Phone:512-447-2422
Mailing Address - Fax:512-447-0914
Practice Address - Street 1:3809 S 2ND ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7036
Practice Address - Country:US
Practice Address - Phone:512-447-2422
Practice Address - Fax:512-447-0914
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4581111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX601859Medicare PIN