MEDICARE: STEPHEN TYLER FORD 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	12059	TX

General Provider Information

NPI Number	:	1427303114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN TYLER FORD D.C.

Provider Business Mailing Address
First Line	:	14688 PERTHSHIRE RD
Second Line	:	UNIT E
City	:	HOUSTON
State	:	TX
Zip	:	77079-7699
Country	:	US
Telephone Number	:	281-770-3613
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 WILCREST DR
Second Line	:	SUITE 3
City	:	HOUSTON
State	:	TX
Zip	:	77042-2752
Country	:	US
Telephone Number	:	713-954-4864
Fax Number	:	713-588-8445

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

Provider Enumeration Date	:	07/18/2012
Last Update Date	:	06/17/2013

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