Individual
EBEL AQUINO MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2236 N LOOP 336 W, CONROE, TX 77304-3519
(800) 404-6050
(866) 313-3397
Mailing address
PO BOX 700688, SAN ANTONIO, TX 78270-0688
(800) 404-6050
(866) 313-3397
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
15247
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15247
CHIROPRACTIC LICENSE
TX
Enumeration date
10/06/2022
Last updated
11/29/2023
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