Provider Demographics
NPI:1245312487
Name:SUMMERS CHIROPRACTIC PROFESSIONAL ASSOCIATION
Entity type:Organization
Organization Name:SUMMERS CHIROPRACTIC PROFESSIONAL ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:SUMMERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:432-523-2400
Mailing Address - Street 1:709 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:ANDREWS
Mailing Address - State:TX
Mailing Address - Zip Code:79714-3616
Mailing Address - Country:US
Mailing Address - Phone:432-523-2400
Mailing Address - Fax:432-523-6153
Practice Address - Street 1:709 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:TX
Practice Address - Zip Code:79714-3616
Practice Address - Country:US
Practice Address - Phone:432-523-2400
Practice Address - Fax:432-523-6153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4302111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0832735-01Medicaid
TX0832735-01Medicaid
TN00J89XMedicare ID - Type UnspecifiedMEDICARE GROUP ID NUMBER