Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 10944 | TX |
Y | 111NR0400X | Rehabilitation Chiropractor | 10944 | TX |
NPI | 1316194194 |
---|---|
Provider Name | Dr. Dennis D Lane |
First Address | Austin, TX 78737-4541 |
Second Address | Austin, TX 78704-2651 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2008 |
Last Update Date | 18/05/2015 |