Provider Demographics
NPI:1194906594
Name:CREATING WELLNESS CHIROPRACTIC
Entity type:Organization
Organization Name:CREATING WELLNESS CHIROPRACTIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CLAUDE
Authorized Official - Last Name:MCCLUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-250-9263
Mailing Address - Street 1:13376 RESEARCH BLVD
Mailing Address - Street 2:STE. 210
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-3237
Mailing Address - Country:US
Mailing Address - Phone:512-250-9263
Mailing Address - Fax:512-250-9264
Practice Address - Street 1:13376 RESEARCH BLVD
Practice Address - Street 2:STE. 210
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-3237
Practice Address - Country:US
Practice Address - Phone:512-250-9263
Practice Address - Fax:512-250-9264
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CREATING WELLNESS CHIROPRACTIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-14
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2891261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00L43LMedicare PIN