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Individual

DR. JEFFREY LEON PRUSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
100 MEDICAL CENTER PKWY STE 100, HUNTSVILLE, TX 77340-4959
(936) 295-1777
(936) 295-3680
Mailing address
100 MEDICAL CENTER PKWY STE 100, HUNTSVILLE, TX 77340-4959
(936) 295-1777
(936) 295-3680

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5291
TX
111NI0013X
Independent Medical Examiner Chiropractor
5291
TX
111NN1001X
Nutrition Chiropractor
5291
TX
111NR0400X
Rehabilitation Chiropractor
5291
TX
111NX0100X
Occupational Health Chiropractor
5291
TX
111NX0800X
Orthopedic Chiropractor
5291
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
760316834
TAX I.D.
TX
01
84V270
BCBS I.D.
TX
Enumeration date
09/25/2006
Last updated
05/10/2024
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