Provider Demographics
NPI:1366285975
Name:DIESTEL FAMILY CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:DIESTEL FAMILY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AO/PROVIDER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:N
Authorized Official - Last Name:DIESTEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:469-554-0328
Mailing Address - Street 1:741 GENERATIONS DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-0513
Mailing Address - Country:US
Mailing Address - Phone:469-554-0328
Mailing Address - Fax:
Practice Address - Street 1:741 GENERATIONS DR STE 200
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-0513
Practice Address - Country:US
Practice Address - Phone:469-554-0328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty