Sandra Ranee Bouldin, D.C.
Individual provider Active NPI Chiropractor · Coleman, TX
NPI 1437220985 · NPPES record last updated Dec 20, 2011
Key facts
- NPI
- 1437220985
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 5266 (TX)
- Practice address
- 1606 S Commercial Ave
Coleman, TX 76834-5018 - Phone
- (325) 625-4163
- Fax
- (325) 625-2065
- NPI assigned
- Nov 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5266 | TX | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pecan Valley Chiropractic & Rehab, LLC | Chiropractor | Past |
Accepting new patients |
| Coleman Chiropractic PLLC | Chiropractor | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5266 | TX | Yes |
Addresses
Primary practice location
1606 S Commercial Ave
Coleman, TX 76834-5018
Mailing address
1606 S Commercial Ave
Coleman, TX 76834-5018
Phone (325) 625-4163
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0015059 | Medicaid | TX |
Other providers in Coleman, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.