Provider Demographics
NPI:1811068158
Name:ALBRACHT, JOHN S (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:ALBRACHT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:JACK
Other - Middle Name:S
Other - Last Name:ALBRACHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:2216 COFFEE ST
Mailing Address - Street 2:
Mailing Address - City:PAMPA
Mailing Address - State:TX
Mailing Address - Zip Code:79065-3511
Mailing Address - Country:US
Mailing Address - Phone:806-665-7161
Mailing Address - Fax:806-665-7162
Practice Address - Street 1:2216 COFFEE ST
Practice Address - Street 2:
Practice Address - City:PAMPA
Practice Address - State:TX
Practice Address - Zip Code:79065-3511
Practice Address - Country:US
Practice Address - Phone:806-665-7161
Practice Address - Fax:806-665-7162
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5208111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT95804Medicare ID - Type Unspecified
TX504-4627Medicare UPIN
TXUT95804Medicare UPIN