Provider Demographics
NPI:1972191773
Name:COWBOY SPINE & PERFORMANCE CENTER PC
Entity Type:Organization
Organization Name:COWBOY SPINE & PERFORMANCE CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:DEAL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:830-714-0006
Mailing Address - Street 1:32665 US HIGHWAY 281 N STE 202
Mailing Address - Street 2:
Mailing Address - City:BULVERDE
Mailing Address - State:TX
Mailing Address - Zip Code:78163-3256
Mailing Address - Country:US
Mailing Address - Phone:830-714-0006
Mailing Address - Fax:830-714-0007
Practice Address - Street 1:32665 US HIGHWAY 281 N STE 202
Practice Address - Street 2:
Practice Address - City:BULVERDE
Practice Address - State:TX
Practice Address - Zip Code:78163-3256
Practice Address - Country:US
Practice Address - Phone:830-714-0006
Practice Address - Fax:830-714-0007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty