DR. MICAH W PITTMAN (NPI# 1740300425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740300425 |
| Entity Type | Individual |
| Full Name | DR. MICAH W PITTMAN |
| Credential | D.C., BSC |
| Practice Address |
1603 Ranch Road 620 N Ste 200 Lakeway TX 78734-2324 |
| Practice Telephone | 5122668100 |
| Practice Fax Number | 5122668103 |
| Mailing Telephone | (425) 457-1980 |
| Mailing Fax Number | 5122668103 |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 13544 | TX | Chiropractic Providers |
| N | 111N00000X | Chiropractor | CH00034578 | WA | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | FIRST CHOICE HEALTH PPO | 460513476 | 01 |
| WA | HEALTHWAYS WHOLEHEALTH | 2006073131740267247 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 13028 Interurban Ave S, Suite 106, Tukwila, WA 981683340 | 4254570469 | 2069577952 |
| Street Address |
1603 RANCH ROAD 620 N STE 200 |
| City | LAKEWAY |
| State | TX |
| Zip Code | 78734-2324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750809513 | 620 Chiropractic & Longevity Center, Pllc | Chiropractor | 1603 Ranch Road 620 N Ste 200, Lakeway, TX 78734-2324 | 2017-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508499757 | Wcs Medical Management LLC | Emergency Medicine | 1700 B Rr 620 South, Austin, TX 78734 | 2020-02-17 |
| 1851930788 | Beasley Counseling Pllc | Counselor | 311 Ranch Road 620 S, Building 311, Suite 102, Lake Travis Business Park, Austin, TX 78734 | 2019-12-23 |
| 1437664067 | Austin Cosmetic Surgery | Surgery | 3102 Rr 620 S, Lakeway, TX 78734 | 2017-12-05 |
| 1568907913 | Pure Pharmacy | Pharmacy | 1927 Lohmans Crossing Rd Ste 203, Lakeway, TX 78734 | 2016-12-21 |
| 1558735050 | Magnolia Instructional Center | Behavioral Analyst | 2903 Rr 620 N, Bldg B, Austin, TX 78734 | 2015-11-20 |
| 1285012815 | H-e-b, Lp | Clinical Medical Laboratory | 2000 Ranch Rd. 620 South Ste A, Lakeway, TX 78734 | 2015-05-15 |
| 1932591385 | Benjamin House | Contractor | 14301 Hunters Pass, Austin, TX 78734 | 2015-02-23 |
| 1215350913 | Yiyang Emily Liu | Nurse Practitioner | 2306 Rent Rd 620 S, Minuteclinic, Lake Way, TX 78734 | 2014-01-31 |
| 1033473905 | Magnolia Instructional Center | Speech-Language Pathologist | 2903 Rr 620 N Bldg B, Austin, TX 78734 | 2012-06-26 |
| 1073830246 | Ricardo Jesus Chapa | Pediatrics | 900 Ranch Road 620 South, Suite C201, Lakeway, TX 78734 | 2010-04-28 |
| Find all providers in zip 78734 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871190629 | Haley Black | Chiropractor | 1310 Ranch Road 620 S Ste B4, Lakeway, TX 78734-6426 | 2020-10-05 |
| 1801212527 | Robert O Burgett | Chiropractor | 107 Ranch Road 620 S, Lakeway, TX 78734-3942 | 2014-03-06 |
| 1962775718 | Aqua Haven Chiropractic | Chiropractor | 107 Ranch Road 620 South, Suite 105, Lakeway, TX 78734-3901 | 2012-02-09 |
| 1548556780 | Stemx of Central Texas, Pllc | Chiropractor | 1310 Rr 620 S., Ste B-4, Lakeway, TX 78734-6243 | 2011-06-27 |
| 1932416054 | James Robert Cordoba | Chiropractor | 1200 Lakeway Dr Ste 17b, Lakeway, TX 78734-4400 | 2010-09-10 |
| 1780706564 | Dustin Ferrell | Chiropractor | 2121 Lohmans Crossing Rd # 508, Lakeway, TX 78734-5217 | 2007-04-04 |
| 1770633125 | Lanny B. Brustein | Chiropractor | 222 Capri, Lakeway, TX 78734-4306 | 2007-01-10 |
| 1942304480 | Andrea Michelle Luise-williams | Chiropractor | 1213 Ranch Road 620 S, Suite #201-b, Lakeway, TX 78734-6340 | 2006-09-12 |
| 1629003884 | Laurence Ryan Smith | Chiropractor | 1603 Ranch Road 620 N, Lakeway, TX 78734-2693 | 2006-07-12 |
| 1366427742 | Todd L Moore | Chiropractor | 1310 Rr 620 S, Ste B-4, Lakeway, TX 78734-6300 | 2005-12-08 |
| Find all providers in LAKEWAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.