Provider Demographics
NPI:1669085452
Name:BUCARELLO MONTOYA, DAYANA PAOLA (DC)
Entity type:Individual
Prefix:DR
First Name:DAYANA
Middle Name:PAOLA
Last Name:BUCARELLO MONTOYA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1704 EAGLES WAY
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-8810
Mailing Address - Country:US
Mailing Address - Phone:512-934-1703
Mailing Address - Fax:
Practice Address - Street 1:10700 ANDERSON MILL RD STE 220
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-2402
Practice Address - Country:US
Practice Address - Phone:512-335-8700
Practice Address - Fax:512-335-8702
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14465111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor