Provider Demographics
NPI:1396808192
Name:NEUERBURG CHIROPRACTIC, L.P.
Entity type:Organization
Organization Name:NEUERBURG CHIROPRACTIC, L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:RASMUSSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-297-7463
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-0008
Mailing Address - Country:US
Mailing Address - Phone:979-297-7463
Mailing Address - Fax:979-297-1881
Practice Address - Street 1:215 FLAGLAKE DR
Practice Address - Street 2:
Practice Address - City:CLUTE
Practice Address - State:TX
Practice Address - Zip Code:77531-5133
Practice Address - Country:US
Practice Address - Phone:979-297-7463
Practice Address - Fax:979-297-1881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2732111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1750389946OtherINDIVIDUAL NPI
TX8M6400OtherBLUE CROSS BLUE SHIELD
TX8M6400OtherBLUE CROSS BLUE SHIELD
TXT15021Medicare UPIN