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Individual

DR. CAROLYN COLE BREAZEALE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
1515 S CAPITAL OF TEXAS HWY, SUITE 220, AUSTIN, TX 78746-6579
(512) 328-3881
(512) 328-3882
Mailing address
1515 S CAPITAL OF TEXAS HWY, SUITE 220, AUSTIN, TX 78746-6579
(512) 328-3881
(512) 328-3882

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2152
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
74-1797945
FEDERAL TAX ID#
TX
05
B06000283
TX
Enumeration date
10/24/2006
Last updated
12/29/2008
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