MEDICARE: MED-C.R.E.W., CORP.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103K00000X	Behavior Analyst
2	208D00000X	General Practice Physician
3	225100000X	Physical Therapist
4	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1437303070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MED-C.R.E.W., CORP.

Provider Business Mailing Address
First Line	:	4826 WASHINGTON AVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-5304
Country	:	US
Telephone Number	:	713-802-2739
Fax Number	:	713-802-1013

Provider Business Practice Location Address
First Line	:	4826 WASHINGTON AVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-5304
Country	:	US
Telephone Number	:	713-802-2739
Fax Number	:	713-802-1013

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. DIRK HUNTER
Credential	:	D.C.
Telephone Number	:	713-802-2739

Provider Enumeration Date	:	11/10/2008
Last Update Date	:	11/10/2008

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Directions to “MED-C.R.E.W., CORP. ” Practice Location

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