Provider Demographics
NPI:1831210921
Name:DR. GOLAB'S CHIROPRACTIC & WELLNESS PA
Entity type:Organization
Organization Name:DR. GOLAB'S CHIROPRACTIC & WELLNESS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:GOLAB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-764-8888
Mailing Address - Street 1:1205 N LOOP 1604 W
Mailing Address - Street 2:SUITE 211
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4624
Mailing Address - Country:US
Mailing Address - Phone:210-764-8888
Mailing Address - Fax:830-460-9329
Practice Address - Street 1:1205 N LOOP 1604 W
Practice Address - Street 2:SUITE 211
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4624
Practice Address - Country:US
Practice Address - Phone:210-764-8888
Practice Address - Fax:210-764-2601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7943111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00281WOtherMEDICARE GROUP
TX8B5006Medicare ID - Type Unspecified
TX00281WOtherMEDICARE GROUP