Greater Texas Clinic of Chiropractic, Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

12143 Issued in TX

Legal business name

GREATER TEXAS CLINIC OF CHIROPRACTIC, INC

Practice address

2205 Longmire Dr
Suite C
College Station, TX 77845-5267

Phone

(979) 693-6800

Fax

(979) 693-6829

NPI assigned

Jun 23, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mark Andrew Mylan, D.C.

Title

President

Phone

(979) 693-6800

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417737600000",
    "number": "1134534779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2117 BLACKJACK DR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778454171",
            "telephone_number": "702-686-9088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 LONGMIRE DR",
            "address_2": "SUITE C",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778455267",
            "telephone_number": "979-693-6800",
            "fax_number": "979-693-6829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER TEXAS CLINIC OF CHIROPRACTIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-23",
        "last_updated": "2014-12-05",
        "status": "A",
        "authorized_official_last_name": "MYLAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "979-693-6800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "12143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaina Gowin
• Elizabeth Grace, NP-C
• Jenna L Grace, APRN, FNP-C
• Heidi Gratz, CCC-SLP
• Charles M Gray, D.D.S.
• Ronald Kyle Greeley, P.T.
• Matthew T Greene, OD
• Sean D Gregorio, BS,RBT
• Kathryn Greiner, M.D.
• Karen J Griffin, CRNA

• Chiropractor in College Station, TX
• Providers in College Station, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.