MEDICARE: SAMUEL SYMMANK 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	DC9044	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8J9011	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1942287768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL SYMMANK D.C.

Provider Business Mailing Address
First Line	:	5100 ELDORADO PKWY
Second Line	:	SUITE 803
City	:	MCKINNEY
State	:	TX
Zip	:	75070-6309
Country	:	US
Telephone Number	:	214-596-2880
Fax Number	:	972-767-0593

Provider Business Practice Location Address
First Line	:	5729 LEBANON RD
Second Line	:	STE 144
City	:	FRISCO
State	:	TX
Zip	:	75034-7259
Country	:	US
Telephone Number	:	214-596-2880
Fax Number	:	972-540-6226

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

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	09/11/2018

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