MEDICARE: ORLAN LEE FIKES 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	111N00000X	Chiropractor	2784	TX

General Provider Information

NPI Number	:	1881629640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ORLAN LEE FIKES D.C.

Provider Business Mailing Address
First Line	:	5309 WURZBACH RD
Second Line	:	STE 114
City	:	SAN ANTONIO
State	:	TX
Zip	:	78238-2431
Country	:	US
Telephone Number	:	210-684-8464
Fax Number	:	210-684-8894

Provider Business Practice Location Address
First Line	:	5309 WURZBACH RD
Second Line	:	STE 114
City	:	SAN ANTONIO
State	:	TX
Zip	:	78238-2431
Country	:	US
Telephone Number	:	210-684-8464
Fax Number	:	210-684-8894

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	10/20/2008

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