Provider Demographics
NPI:1750547832
Name:LIVE OAK CHIROPRACTIC
Entity type:Organization
Organization Name:LIVE OAK CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:FALKE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-772-3088
Mailing Address - Street 1:651 N US HIGHWAY 183
Mailing Address - Street 2:SUITE 155
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-8990
Mailing Address - Country:US
Mailing Address - Phone:512-772-3088
Mailing Address - Fax:
Practice Address - Street 1:651 N US HIGHWAY 183
Practice Address - Street 2:SUITE 155
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-8990
Practice Address - Country:US
Practice Address - Phone:512-772-3088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10854111NP0017X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NP0017XChiropractic ProvidersChiropractorPediatric ChiropractorGroup - Multi-Specialty