Lake Travis Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

10965 Issued in TX

Legal business name

LAKE TRAVIS CHIROPRACTIC

Doing business as

620 Chiropractic Center

Practice address

1700 Ranch Road 620 N Ste 108
Lakeway, TX 78734-2788

Phone

(737) 359-0888

Fax

(512) 727-5658

NPI assigned

Feb 16, 2009

Last updated

Feb 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Laurence Ryan Smith, D.C.NPI 1629003884

Title

Doctor/ Owner

Phone

(808) 639-1272

Specialties & licenses 1

Addresses

Other names 1

• 620 Chiropractic Center Doing business as

Locations

Practitioners 1

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.

• Laurence Ryan Smith, D.C.

  • Chiropractor
  • Lakeway, TX
  • NPI 1629003884
  Authorized official Same address or phone

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

{
    "created_epoch": "1234742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707091200000",
    "number": "1598904559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 RANCH ROAD 620 N STE 108",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787342788",
            "telephone_number": "737-359-0888",
            "fax_number": "512-727-5658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 RANCH ROAD 620 N STE 108",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787342788",
            "telephone_number": "737-359-0888",
            "fax_number": "512-727-5658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE TRAVIS CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-16",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "LAURENCE",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "DOCTOR/ OWNER",
        "authorized_official_telephone_number": "808-639-1272",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "10965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "620 Chiropractic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tara Kulkarni, DO
• Pratiksha Kuppusamy, RPH
• Kurt Von Rueden, MD, PA (Austin Spine)
• Alexandra Marie La Plant, PT, DPT
• Parker Laborde
• Lake Travis Chiropractic, PLLC
• Lake Travis Counseling Connection PLLC
• Lake Travis Eye and Laser Center, PA
• Lake Travis Family & Cosmetic Dentistry PLLC (Lake Travis Dentistry)
• Lake Travis Oral & Maxillofacial Surgery, PLLC.

• Chiropractor in Lakeway, TX
• Providers in Lakeway, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.