Provider Demographics
NPI:1144474982
Name:CCT CHIROPRACTIC CENTERS OF TEXAS AT ALAMO HEIGHTS
Entity type:Organization
Organization Name:CCT CHIROPRACTIC CENTERS OF TEXAS AT ALAMO HEIGHTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:F
Authorized Official - Last Name:PUHL
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:210-828-2665
Mailing Address - Street 1:147 W SUNSET RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-2676
Mailing Address - Country:US
Mailing Address - Phone:210-828-2665
Mailing Address - Fax:210-826-2661
Practice Address - Street 1:147 W SUNSET RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-2676
Practice Address - Country:US
Practice Address - Phone:210-828-2665
Practice Address - Fax:210-826-2661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-06
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7325111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX604140Medicare PIN