Provider Demographics
NPI:1134630940
Name:SIECZKOWSKI, ALEX (DC)
Entity type:Individual
Prefix:DR
First Name:ALEX
Middle Name:
Last Name:SIECZKOWSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ALEX
Other - Middle Name:
Other - Last Name:LOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:280 N BUSINESS IH 35 STE 300
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-7867
Mailing Address - Country:US
Mailing Address - Phone:210-549-8097
Mailing Address - Fax:
Practice Address - Street 1:280 N BUSINESS IH 35 STE 300
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-7867
Practice Address - Country:US
Practice Address - Phone:210-549-8097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-19
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13507111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor