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General NPI Number Information
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NPI Number | 1487865820
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Entity Type | Organization
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Legal Business Name | CENTRAL TX CHIROPRACTIC & REHABILITATION CLINICS, INC
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 10/16/2007
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Provider Practice Location Address
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Address Line | 1333 W. HWY 1431
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City | KINGSLAND
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State | TX
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Zip | 78639
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Country | US
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Telephone | 325-388-2969
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Fax | 325-388-2790
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Provider Business Mailing Address
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Address Line | PO BOX 1231
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City | KINGSLAND
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State | TX
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Zip | 78639-1231
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Country | US
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Telephone | 325-388-2969
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Fax | 325-388-2790
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHAWN RAY SCOTT
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Credential | D.C.
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Telephone | 325-388-2969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 8479
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License Number State | TX
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