Provider Demographics
NPI:1487024295
Name:MICHENER, ERIK EUGENE (DC)
Entity type:Individual
Prefix:
First Name:ERIK
Middle Name:EUGENE
Last Name:MICHENER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 CENTRAL PKWY N STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-5053
Mailing Address - Country:US
Mailing Address - Phone:210-249-4874
Mailing Address - Fax:
Practice Address - Street 1:911 CENTRAL PKWY N STE 300
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-5053
Practice Address - Country:US
Practice Address - Phone:210-249-4874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-06
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4480111NS0005X
MO2014039521111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician