Provider Demographics
NPI:1902311103
Name:TAPROOT CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:TAPROOT CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELICA
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:BECERRA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:830-885-4477
Mailing Address - Street 1:17130 HIGHWAY 46 W STE 110A
Mailing Address - Street 2:
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-7092
Mailing Address - Country:US
Mailing Address - Phone:830-885-4477
Mailing Address - Fax:830-885-6677
Practice Address - Street 1:17130 HIGHWAY 46 W STE 110A
Practice Address - Street 2:
Practice Address - City:SPRING BRANCH
Practice Address - State:TX
Practice Address - Zip Code:78070-7092
Practice Address - Country:US
Practice Address - Phone:830-885-4477
Practice Address - Fax:830-885-6677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-11
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12175111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty