Provider Demographics
NPI:1740368661
Name:MINORS, STEVE L (DC)
Entity type:Individual
Prefix:DR
First Name:STEVE
Middle Name:L
Last Name:MINORS
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 1:4006 S LAMAR BLVD
Mailing Address - Street 2:STE 650
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-8802
Mailing Address - Country:US
Mailing Address - Phone:512-480-9999
Mailing Address - Fax:
Practice Address - Street 1:4532 W GATE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1410
Practice Address - Country:US
Practice Address - Phone:512-480-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC 7035111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX76HJOtherBCBS FACILITY PROVIDER
TXDC 7035OtherPROF. LICENSE NUMBER
TX76HJOtherBCBS FACILITY PROVIDER
TXTXB140622Medicare UPIN