1427233139 NPI number — MATT PARSONS CHIROPRACTIC ASSOCIATES, INC.

Table of content: CARLOS MANUEL PAISAN MD (NPI 1609893411)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427233139 NPI number — MATT PARSONS CHIROPRACTIC ASSOCIATES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MATT PARSONS CHIROPRACTIC ASSOCIATES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427233139
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1009 CHESTNUT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BASTROP
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78602-3303
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-321-9604
Provider Business Mailing Address Fax Number:
512-581-9600

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1009 CHESTNUT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BASTROP
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78602-3303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-321-9604
Provider Business Practice Location Address Fax Number:
512-581-9600
Provider Enumeration Date:
01/02/2008

Additional Information

Authorized Official

Authorized Official Last Name:
PARSONS
Authorized Official First Name:
MATTHEW
Authorized Official Middle Name:
HENRY
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
512-321-9604

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  9845 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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