MEDICARE: KEVIN L. MCNABB

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	111NN0400X	Neurology Chiropractor	6460	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811946940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN L. MCNABB

Provider Business Mailing Address
First Line	:	2019B S HENDERSON BLVD
Second Line	:	STE. 8
City	:	KILGORE
State	:	TX
Zip	:	75662-3546
Country	:	US
Telephone Number	:	903-984-5522
Fax Number	:	903-984-5547

Provider Business Practice Location Address
First Line	:	2019B S HENDERSON BLVD
Second Line	:	STE. 8
City	:	KILGORE
State	:	TX
Zip	:	75662-3546
Country	:	US
Telephone Number	:	903-984-5522
Fax Number	:	903-984-5547

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

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	07/08/2007

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Directions to “ KEVIN L. MCNABB ” Practice Location

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