Individual
DR. DOUGLAS STAKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
7413 OLD BEE CAVES RD, AUSTIN, TX 78735-8234
(512) 892-2160
(512) 892-7309
Mailing address
9609 STREAMSIDE DR, AUSTIN, TX 78736-2411
(512) 892-2160
(512) 892-7309
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2312
OK
111N00000X
Chiropractor
Primary
2943
TX
111N00000X
Chiropractor
483
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350005894
RAILROAD MEDICARE
TX
01
—
6001179
BCBS
TX
Enumeration date
08/31/2006
Last updated
07/21/2021
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