BRANDON GRIMM D.C. P.A. (NPI# 1619059060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619059060 |
| Entity Type | Organization |
| Organization Name | BRANDON GRIMM D.C. P.A. |
| Other Organization Name | CANYON CHIROPRACTIC |
| Practice Address |
14812 South Access Road Canyon Lake TX 78133 |
| Practice Telephone | 8309073811 |
| Practice Fax Number | 8309073812 |
| Mailing Telephone | 8309073811 |
| Mailing Fax Number | 8309073812 |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. BRANDON W GRIMM (PRESIDENT/OWNER) |
| Authorized Official Telephone | 8309073811 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 9268 | TX | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | INDIVIDUAL NPI # | 1033146170 | 01 |
| TX | BLUE CROSS BLUE SHIELD | 8U9450 | 01 |
| Other Name | Type Code |
|---|---|
| Canyon Chiropractic | Doing Business As Name - Organization |
| Street Address |
14812 SOUTH ACCESS ROAD |
| City | CANYON LAKE |
| State | TX |
| Zip Code | 78133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891309571 | Amanda Mills | Registered Nurse | 1811 Montview, Canyon Lake, TX 78133 | 2020-09-01 |
| 1104301902 | Jannah Holley Vise | Acupuncturist | 190 Crazy Horse Trail, Canyon Lake, TX 78133 | 2018-09-27 |
| 1023480555 | Brookshire Brothers Inc | Pharmacy | 18275 Fm 306, Canyon Lake, TX 78133 | 2015-10-23 |
| 1154440873 | Jose P. Morin | Specialist/Technologist, Other | 623 Marlys Ave, Canyon Lake, TX 78133 | 2007-03-28 |
| 1649543455 | Jeffrey Quentin Harper | Chiropractor | 1742 Fm 2673, Canyon Lake, TX 78133 | 2012-02-10 |
| 1225348048 | Hill Country Surgical Assistants | Specialist/Technologist, Other | 623 Marlys Ave, Canyon Lake, TX 78133 | 2010-10-14 |
| 1376554253 | Don Coleman | Rehabilitation Practitioner | 111 Toye Blvd, Canyon Lake, TX 78133 | 2006-08-10 |
| 1063943041 | Windmill Wellness Ranch LLC | Substance Abuse Rehabilitation Facility | 26229 N Cranes Mill Rd, Canyon Lake, TX 78133-1957 | 2017-03-22 |
| 1174143051 | Joseph Lee Kastigar | Peer Specialist | 26229 N Cranes Mill Rd, Canyon Lake, TX 78133-1957 | 2020-04-21 |
| 1083250799 | Lynette Slebrch | Counselor | 26229 N Cranes Mill Rd, Canyon Lake, TX 78133-1957 | 2019-11-18 |
| Find all providers in zip 78133 | ||||
| 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 |
|---|---|---|---|---|
| 1063730604 | Advanced Chiropratic and Sports Care LLC | Chiropractor | 31610 Railroad Canyon Rd Ste 4, Canyon Lake, CA 92587-9454 | 2010-05-06 |
| 1508193392 | Ku Il Lee | Chiropractor | 29806 Santa Maria Dr, Canyon Lake, CA 92587-7426 | 2009-11-16 |
| 1861678955 | Jeffrey C.swink Chiropracitic Inc. | Chiropractor | 31508 Railroad Canyon Rd, Canyon Lake, CA 92587-9413 | 2008-01-18 |
| 1164548632 | John Maurice Allen | Chiropractor | 32150 Railroad Canyon Rd, Canyon Lake, CA 92587-9212 | 2007-03-22 |
| 1679622781 | Sandee R Fabling | Chiropractor | 1742 Fm 2673, Canyon Lake, TX 78133-4743 | 2007-01-09 |
| 1649288630 | Julie Zimmerer | Chiropractor | 31610 Railroad Canyon Rd, #5, Canyon Lake, CA 92587-9454 | 2006-08-04 |
| 1649543455 | Jeffrey Quentin Harper | Chiropractor | 1742 Fm 2673, Canyon Lake, TX 78133 | 2012-02-10 |
| 1326210337 | J.c. Swink Chiropractic Inc. | Chiropractor | 31532 Railroad Canyon Rd, Suite 112, Canyon Lake, CA 92587-9437 | 2008-03-31 |
| 1689895872 | Hill Country Chiropractic Clinic | Chiropractor | 1742 Fm 2673, Canyon Lake, TX 78133-4743 | 2007-05-02 |
| 1093839698 | Jeff C. Swink | Chiropractor | 31532 Railroad Canyon Rd, Suite 112, Canyon Lake, CA 92587-9437 | 2007-03-19 |
| Find all providers in CANYON LAKE | ||||
| City | CANYON LAKE |
| Zip Code | 78133 |
Please comment or provide details below to improve the information on BRANDON GRIMM D.C. P.A..
| 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.