Provider Demographics
NPI:1336264365
Name:OSBORNE FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:OSBORNE FAMILY CHIROPRACTIC
Other - Org Name:TEAM OFC, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:OSBORNE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-255-9711
Mailing Address - Street 1:1208 N. IH-35
Mailing Address - Street 2:W
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681
Mailing Address - Country:US
Mailing Address - Phone:512-255-9711
Mailing Address - Fax:512-255-6545
Practice Address - Street 1:1208 N. IH-35
Practice Address - Street 2:W
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681
Practice Address - Country:US
Practice Address - Phone:512-255-9711
Practice Address - Fax:512-255-6545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6996111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX612356Medicare PIN