Provider Demographics
NPI:1386705630
Name:LUNDRIGAN, RONALD A (DC)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:A
Last Name:LUNDRIGAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 292
Mailing Address - Street 2:
Mailing Address - City:MCDADE
Mailing Address - State:TX
Mailing Address - Zip Code:78650-0292
Mailing Address - Country:US
Mailing Address - Phone:512-308-9444
Mailing Address - Fax:512-308-9444
Practice Address - Street 1:551 HERRON TRAIL
Practice Address - Street 2:
Practice Address - City:MCDADE
Practice Address - State:TX
Practice Address - Zip Code:78650-5107
Practice Address - Country:US
Practice Address - Phone:512-285-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10565111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX613005Medicare PIN