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Organization
MICHAEL F. VANDEWALLE P.C.
Active
Organization
MICHAEL F. VANDEWALLE P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL F VANDEWALLE D.C (DR./OWNER)
(512) 343-0700
Entity
Organization
Contact information
Practice address
11824 JOLLYVILLE RD, SUITE 500, AUSTIN, TX 78759-2322
(512) 343-0700
(512) 343-0775
Mailing address
11824 JOLLYVILLE RD, SUITE 500, AUSTIN, TX 78759-2322
(512) 343-0700
(512) 343-0775
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
11404
TX
111N00000X
Chiropractor
Primary
2771
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11404
CHIROPRACTIC LICENSE
TX
01
—
2771
STATE LICENSE
TX
01
—
8P0221
BCBS
TX
05
—
C06060612
—
TX
Enumeration date
08/21/2007
Last updated
03/17/2010
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