NPIMap

Organization Active NPI

Dudycha Chiropractic

  • Rehabilitation Chiropractor
  • Canyon Lake, TX
National Provider Identifier
1588853071
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
10132 Issued in TX
Legal business name
DUDYCHA CHIROPRACTIC
Practice address
14812 S Access Rd BLDG a
Canyon Lake, TX 78133-4132
Phone
(830) 907-3811
NPI assigned
Oct 19, 2007
Last updated
Oct 19, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

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

Authorized official

Name
Dr. Justin Dudycha, D.C.NPI 1093828808
Title
Chiropractor
Phone
(830) 907-3811

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 10132 TX Primary

Addresses

Primary practice location

14812 S Access Rd BLDG a
Canyon Lake, TX 78133-4132

Mailing address

14812 S Access Rd BLDG a
Canyon Lake, TX 78133-4132
Phone (830) 907-3811

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1192752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192752000000",
    "number": "1588853071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14812 S ACCESS RD BLDG A",
            "city": "CANYON LAKE",
            "state": "TX",
            "postal_code": "781334132",
            "telephone_number": "830-907-3811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14812 S ACCESS RD BLDG A",
            "city": "CANYON LAKE",
            "state": "TX",
            "postal_code": "781334132",
            "telephone_number": "830-907-3811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUDYCHA CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-19",
        "last_updated": "2007-10-19",
        "status": "A",
        "authorized_official_last_name": "DUDYCHA",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "830-907-3811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "TX",
            "license": "10132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canyon Lake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; 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.