Provider Demographics
NPI:1215471420
Name:KOPAS CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:KOPAS CHIROPRACTIC, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CORY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:KOPAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:325-793-9989
Mailing Address - Street 1:4150 SOUTHWEST DR
Mailing Address - Street 2:SUITE 114
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-8222
Mailing Address - Country:US
Mailing Address - Phone:325-793-9989
Mailing Address - Fax:325-793-9963
Practice Address - Street 1:4150 SOUTHWEST DR
Practice Address - Street 2:SUITE 114
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-8222
Practice Address - Country:US
Practice Address - Phone:325-793-9989
Practice Address - Fax:325-793-9963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13315111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty