Individual
DR. JAY MANGUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
21770 KINGSLAND BLVD, KATY, TX 77450-2513
(800) 404-6050
(866) 313-3397
Mailing address
PO BOX 700688, SAN ANTONIO, TX 78270-0688
(210) 477-7654
(210) 468-0682
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
13577
TX
111N00000X
Chiropractor
CHIA-1725
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13577
TEXAS BOARD OF CHIROPRACTIC EXAMINERS
TX
Enumeration date
07/08/2016
Last updated
07/19/2019
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