Provider Demographics
NPI:1295736601
Name:SNOW, MICHAEL J (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:SNOW
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 1:8440 BURNET RD
Mailing Address - Street 2:STE 118
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-7013
Mailing Address - Country:US
Mailing Address - Phone:512-459-4014
Mailing Address - Fax:512-459-4017
Practice Address - Street 1:8440 BURNET RD
Practice Address - Street 2:STE 118
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-7013
Practice Address - Country:US
Practice Address - Phone:512-459-4014
Practice Address - Fax:512-459-4017
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6938111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
14124Medicare UPIN
TX605413Medicare ID - Type Unspecified