Provider Demographics
NPI:1891232732
Name:MOYA CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:MOYA CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:ZARATE
Authorized Official - Last Name:MOYA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:956-605-4440
Mailing Address - Street 1:24165 W IH 10
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257-1114
Mailing Address - Country:US
Mailing Address - Phone:210-698-1700
Mailing Address - Fax:210-698-3400
Practice Address - Street 1:24165 W IH 10
Practice Address - Street 2:SUITE 106
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257-1114
Practice Address - Country:US
Practice Address - Phone:210-698-1700
Practice Address - Fax:210-698-3400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10833111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty