Provider Demographics
NPI:1699795187
Name:GESKE, DEAN ANDREW (DC)
Entity type:Individual
Prefix:DR
First Name:DEAN
Middle Name:ANDREW
Last Name:GESKE
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 1:3309 FOREST CREEK DR UNIT 101
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-6168
Mailing Address - Country:US
Mailing Address - Phone:512-310-7177
Mailing Address - Fax:512-852-4766
Practice Address - Street 1:3309 FOREST CREEK DR UNIT 101
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-6168
Practice Address - Country:US
Practice Address - Phone:512-310-7177
Practice Address - Fax:512-852-4766
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28234111N00000X
TX12361111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA33-1039880Medicare UPIN
CADC28234Medicare PIN