Provider Demographics
NPI:1255423794
Name:KIRKPATRICK, IRA PAUL (DC)
Entity type:Individual
Prefix:DR
First Name:IRA
Middle Name:PAUL
Last Name:KIRKPATRICK
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 1:311 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-4292
Mailing Address - Country:US
Mailing Address - Phone:830-896-4108
Mailing Address - Fax:830-896-4120
Practice Address - Street 1:311 W MAIN ST
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-4292
Practice Address - Country:US
Practice Address - Phone:830-896-4108
Practice Address - Fax:830-896-4120
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6081111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8238112OtherBLUE LINK
TX604026Medicare ID - Type Unspecified
TX8238112OtherBLUE LINK