MEDICARE: DR. SHEA STARK 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	CHI-CHI-LIC-3454	MT

General Provider Information

NPI Number	:	1639568405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHEA STARK DC

Provider Business Mailing Address
First Line	:	8500 CYPRESSWOOD DR STE 207
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-7109
Country	:	US
Telephone Number	:	281-547-8930
Fax Number	:	844-473-1290

Provider Business Practice Location Address
First Line	:	8500 CYPRESSWOOD DR STE 207
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-7109
Country	:	US
Telephone Number	:	281-547-8930
Fax Number	:	844-473-1290

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

Provider Enumeration Date	:	01/16/2015
Last Update Date	:	02/09/2026

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Directions to “ DR. SHEA STARK DC” Practice Location

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