Provider Demographics
NPI:1427353416
Name:WESTLAKE CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:WESTLAKE CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATERINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEFFIELD-DICKEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC, RPH
Authorized Official - Phone:512-306-1625
Mailing Address - Street 1:17209 WHIPPOORWILL TRL
Mailing Address - Street 2:
Mailing Address - City:LAGO VISTA
Mailing Address - State:TX
Mailing Address - Zip Code:78645-8032
Mailing Address - Country:US
Mailing Address - Phone:512-619-1335
Mailing Address - Fax:512-328-5114
Practice Address - Street 1:300 BEARDSLEY LN
Practice Address - Street 2:BLDG C101
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-4945
Practice Address - Country:US
Practice Address - Phone:512-306-1625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-21
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11499111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty