Provider Demographics
NPI:1669438164
Name:PLUMB, CALVIN WAYNE (DC)
Entity type:Individual
Prefix:
First Name:CALVIN
Middle Name:WAYNE
Last Name:PLUMB
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 1:952 GRUENE RD STE 150
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-3934
Mailing Address - Country:US
Mailing Address - Phone:830-626-1200
Mailing Address - Fax:866-781-4445
Practice Address - Street 1:952 GRUENE RD STE 150
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3934
Practice Address - Country:US
Practice Address - Phone:830-626-1200
Practice Address - Fax:866-781-4445
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-24
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9996111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXV05329Medicare UPIN
TX611831Medicare ID - Type Unspecified