MEDICARE: WALTER L ADAMS DC PC

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	2606	TX

General Provider Information

NPI Number	:	1649537861
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALTER L ADAMS DC PC

Provider Business Mailing Address
First Line	:	5913 LOVELL AVE
Second Line	:	SUITE B
City	:	FORT WORTH
State	:	TX
Zip	:	76107-5069
Country	:	US
Telephone Number	:	817-731-6921
Fax Number	:	817-763-9533

Provider Business Practice Location Address
First Line	:	5913 LOVELL AVE
Second Line	:	SUITE B
City	:	FORT WORTH
State	:	TX
Zip	:	76107-5069
Country	:	US
Telephone Number	:	817-731-6921
Fax Number	:	817-763-9535

Authorized Official
Title or Position	:	OWNER
Name	:	DR. WALTER ADAMS
Credential	:	D.C.,
Telephone Number	:	817-731-6921

Provider Enumeration Date	:	04/12/2012
Last Update Date	:	04/12/2012

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