Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 10433 | TX |
N | 111NS0005X | Chiropractic Sports Physician | 10433 | TX |
NPI | 1144242074 |
---|---|
Provider Name | Dr. Brian Steven Schtupak |
First Address | Harlingen, TX 78552-2319 |
Second Address | Albuquerque, NM 87110-6359 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2006 |
Last Update Date | 07/10/2014 |