Provider Demographics
NPI:1447831276
Name:AMEN, KEVIN BRYAN (DC)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:BRYAN
Last Name:AMEN
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 1:160 CREEKSIDE PARK RD.
Mailing Address - Street 2:STE. 100
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-6150
Mailing Address - Country:US
Mailing Address - Phone:830-980-8200
Mailing Address - Fax:830-438-8204
Practice Address - Street 1:160 CREEKSIDE PARK RD.
Practice Address - Street 2:STE. 100
Practice Address - City:SPRING BRANCH
Practice Address - State:TX
Practice Address - Zip Code:78070-6150
Practice Address - Country:US
Practice Address - Phone:830-980-8200
Practice Address - Fax:830-438-8204
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-14
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4060111NS0005X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician