Provider Demographics
NPI:1447931290
Name:APONTE QUINTANA, CORALIZ (DC)
Entity type:Individual
Prefix:
First Name:CORALIZ
Middle Name:
Last Name:APONTE QUINTANA
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 1:3233 HARMON AVE UNIT 321
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-4680
Mailing Address - Country:US
Mailing Address - Phone:864-205-3885
Mailing Address - Fax:
Practice Address - Street 1:11800 N INTERSTATE 35
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-2211
Practice Address - Country:US
Practice Address - Phone:512-284-8660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14950111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor