Provider Demographics
NPI:1396155404
Name:ONSITE CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:ONSITE CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELAROSA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-762-5880
Mailing Address - Street 1:PO BOX 4098
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78765-4098
Mailing Address - Country:US
Mailing Address - Phone:512-762-5880
Mailing Address - Fax:512-580-8447
Practice Address - Street 1:1929 PAYTON GIN RD.
Practice Address - Street 2:STE E
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757
Practice Address - Country:US
Practice Address - Phone:512-762-5880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ONSITE CHIROPRACTIC, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-29
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6981111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty