Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 9197 | TX |
NPI | 1235140906 |
---|---|
Provider Name | Dr. Julio C Regalado |
First Address | San Antonio, TX 78201-6523 |
Second Address | San Antonio, TX 78201-6523 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9197 | LIC (01) | TX |