Basic Information
| Provider Information | |||||||||
| NPI: | 1538292578 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DEVRIES FAMILY CHIROPRACTIC, P.A. | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 187A KIRKHAM CIRLCE | ||||||||
| Address2: | |||||||||
| City: | KYLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78640 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124050400 | ||||||||
| FaxNumber: | 5124050403 | ||||||||
| Practice Location | |||||||||
| Address1: | 187A KIRKHAM CIRLCE | ||||||||
| Address2: | |||||||||
| City: | KYLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78640 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124050400 | ||||||||
| FaxNumber: | 5124050403 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/13/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | DEVRIES | ||||||||
| AuthorizedOfficialFirstName: | WENDY | ||||||||
| AuthorizedOfficialMiddleName: | ANN | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5124050400 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | D.C. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 9607 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Chiropractic Providers | Chiropractor |
No ID Information.