Provider Demographics
NPI:1013463678
Name:LACROIX CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:LACROIX CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:LACROIX
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-657-1057
Mailing Address - Street 1:425 WOODWARD ST.
Mailing Address - Street 2:BUILDING B SUITE 102
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-7231
Mailing Address - Country:US
Mailing Address - Phone:512-710-6264
Mailing Address - Fax:512-904-7574
Practice Address - Street 1:425 WOODWARD ST STE 102
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7231
Practice Address - Country:US
Practice Address - Phone:512-710-6264
Practice Address - Fax:512-904-7574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13032111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty