MEDICARE: DR. JARRAD ANTHONY MARTIN 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	12582	TX

General Provider Information

NPI Number	:	1023438124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JARRAD ANTHONY MARTIN D.C.

Provider Business Mailing Address
First Line	:	4011 W PLANO PKWY
Second Line	:	STE 115
City	:	PLANO
State	:	TX
Zip	:	75093-5629
Country	:	US
Telephone Number	:	972-900-3600
Fax Number	:

Provider Business Practice Location Address
First Line	:	4011 W PLANO PKWY
Second Line	:	STE 115
City	:	PLANO
State	:	TX
Zip	:	75093-5629
Country	:	US
Telephone Number	:	972-900-3600
Fax Number	:

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

Provider Enumeration Date	:	04/16/2014
Last Update Date	:	05/12/2016

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