MEDICARE: AVERY DESIGN CO

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	111NI0900X	Internist Chiropractor	11329	TX

General Provider Information

NPI Number	:	1861723678
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVERY DESIGN CO

Provider Business Mailing Address
First Line	:	3764 WALDORF DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75229-3936
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4100 MCEWEN RD
Second Line	:	STE 130
City	:	DALLAS
State	:	TX
Zip	:	75244-5113
Country	:	US
Telephone Number	:	972-836-6090
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. AVERY K CARPENTER
Credential	:	DC
Telephone Number	:	972-836-6090

Provider Enumeration Date	:	01/18/2010
Last Update Date	:	01/05/2015

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Directions to “AVERY DESIGN CO ” Practice Location

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