MEDICARE: DR. STEVEN RAY ELLIOTT 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	111NX0800X	Orthopedic Chiropractor	DC2481	TX

General Provider Information

NPI Number	:	1487635058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN RAY ELLIOTT D.C.

Provider Business Mailing Address
First Line	:	3906 S MEDFORD DR
Second Line	:
City	:	LUFKIN
State	:	TX
Zip	:	75901-5754
Country	:	US
Telephone Number	:	936-639-1014
Fax Number	:	936-639-1099

Provider Business Practice Location Address
First Line	:	3906 S MEDFORD DR
Second Line	:
City	:	LUFKIN
State	:	TX
Zip	:	75901-5754
Country	:	US
Telephone Number	:	936-639-1014
Fax Number	:	936-639-1099

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

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	07/08/2007

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