MEDICARE: ANNIESHA SCOTT D.C.

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	12991	TX

General Provider Information

NPI Number	:	1114388675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNIESHA SCOTT D.C.

Provider Business Mailing Address
First Line	:	1125 COPAL DR
Second Line	:
City	:	AUBREY
State	:	TX
Zip	:	76227-2105
Country	:	US
Telephone Number	:	214-437-5311
Fax Number	:

Provider Business Practice Location Address
First Line	:	2459 E HEBRON PKWY STE 130
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75010-4477
Country	:	US
Telephone Number	:	214-437-5311
Fax Number	:

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

Provider Enumeration Date	:	03/11/2016
Last Update Date	:	07/13/2020

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