MEDICARE: MARIE C BIELAMOWICZ-TYNAN DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC7969	TX

General Provider Information

NPI Number	:	1093927287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE C BIELAMOWICZ-TYNAN DC

Provider Business Mailing Address
First Line	:	PO BOX 7527
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77270-7527
Country	:	US
Telephone Number	:	713-861-6186
Fax Number	:	713-861-6186

Provider Business Practice Location Address
First Line	:	3206 WHITE OAK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-2642
Country	:	US
Telephone Number	:	713-861-6186
Fax Number	:	713-861-6186

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	07/08/2007

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