Provider Demographics
NPI:1336268945
Name:SAN JACINTO CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:SAN JACINTO CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:LAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-499-0366
Mailing Address - Street 1:816 CONGRESS AVE STE 980
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-2490
Mailing Address - Country:US
Mailing Address - Phone:512-499-0366
Mailing Address - Fax:
Practice Address - Street 1:816 CONGRESS AVE STE 980
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-2490
Practice Address - Country:US
Practice Address - Phone:512-499-0366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7159111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty