Provider Demographics
NPI:1649637109
Name:KIRK, ELIZABETH KEENAN (DC)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:KEENAN
Last Name:KIRK
Suffix:
Gender:
Credentials:DC
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:KEENAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 700688
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78270-0688
Mailing Address - Country:US
Mailing Address - Phone:210-477-7654
Mailing Address - Fax:210-468-0682
Practice Address - Street 1:2810 OAK RUN PKWY STE 200
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132-4763
Practice Address - Country:US
Practice Address - Phone:800-404-6050
Practice Address - Fax:866-313-3397
Is Sole Proprietor?:No
Enumeration Date:2016-01-28
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13473111N00000X, 111NR0400X
VA0104-557306111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX13473OtherTEXAS BOARD OF CHIROPRACTIC EXAMINERS