Provider Demographics
NPI:1992794739
Name:KUNISCH, ROBERT (DC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:KUNISCH
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 1:816 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:TX
Mailing Address - Zip Code:76574-3228
Mailing Address - Country:US
Mailing Address - Phone:512-352-5285
Mailing Address - Fax:512-352-5286
Practice Address - Street 1:816 N MAIN ST
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:TX
Practice Address - Zip Code:76574-3228
Practice Address - Country:US
Practice Address - Phone:512-352-5285
Practice Address - Fax:512-352-5286
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4255111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX601627Medicare ID - Type Unspecified
T14294Medicare UPIN