=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558330084
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SANDRA M POWERS D.C.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/16/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2710 N JOSEY LN SUITE 301
-----------------------------------------------------
City | CARROLLTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75007-5400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-483-3550
-----------------------------------------------------
Fax | 888-358-8913
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5250 PUEBLO LN
-----------------------------------------------------
City | FRISCO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75034-1222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 831-251-0006
-----------------------------------------------------
Fax | 888-358-8913
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 10095
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 29237
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------