Provider Demographics
NPI:1003926692
Name:ULERY, JEFFREY R (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:R
Last Name:ULERY
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 1:2525 WALLINGWOOD DR
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6900
Mailing Address - Country:US
Mailing Address - Phone:512-328-5200
Mailing Address - Fax:512-732-2070
Practice Address - Street 1:2525 WALLINGWOOD DR
Practice Address - Street 2:SUITE 1500
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6900
Practice Address - Country:US
Practice Address - Phone:512-328-5200
Practice Address - Fax:512-732-2070
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9429111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F23241OtherMEDICARE PTAN
TXU86860Medicare UPIN