Provider Demographics
NPI:1598640880
Name:WILSON & SIBERT CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:WILSON & SIBERT CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CAREY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEGREST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-896-2273
Mailing Address - Street 1:PO BOX 291077
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78029-1077
Mailing Address - Country:US
Mailing Address - Phone:830-896-2273
Mailing Address - Fax:830-896-2275
Practice Address - Street 1:133 W WATER ST
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-5243
Practice Address - Country:US
Practice Address - Phone:830-896-2273
Practice Address - Fax:830-896-2673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-07
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1063467678OtherNPPES
TX1871782151OtherNPPES