Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 4624 | TX |
N | 111NN1001X | Nutrition | 4624 | TX |
N | 111NR0400X | Rehabilitation Chiropractor | 4624 | TX |
NPI | 1326171927 |
---|---|
Provider Name | Dr. Colette Yvonne Zygmont |
First Address | Austin, TX 78704-1509 |
Second Address | Austin, TX 78704-1509 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2007 |
Last Update Date | 20/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1096489-01 | (05) | TX |