Provider Demographics
NPI:1174700579
Name:ZYGMONT FAMILY CHIROPRACTIC, INC.
Entity type:Organization
Organization Name:ZYGMONT FAMILY CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:DARIUS
Authorized Official - Last Name:ZYGMONT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-288-5502
Mailing Address - Street 1:5900 W SLAUGHTER LN
Mailing Address - Street 2:STE. 470
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-6511
Mailing Address - Country:US
Mailing Address - Phone:512-288-5502
Mailing Address - Fax:512-288-6529
Practice Address - Street 1:5900 W SLAUGHTER LN
Practice Address - Street 2:STE. 470
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-6511
Practice Address - Country:US
Practice Address - Phone:512-288-5502
Practice Address - Fax:512-288-6529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8017111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty