MEDICARE: ADJUST PHYSICAL MEDICINE PLLC

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	208D00000X	General Practice Physician	G4779	TX

General Provider Information

NPI Number	:	1023490661
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADJUST PHYSICAL MEDICINE PLLC

Provider Business Mailing Address
First Line	:	13450 INWOOD RD STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75244-5324
Country	:	US
Telephone Number	:	972-701-9355
Fax Number	:	972-701-9357

Provider Business Practice Location Address
First Line	:	13450 INWOOD RD STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75244-5324
Country	:	US
Telephone Number	:	972-701-9355
Fax Number	:	972-701-9357

Authorized Official
Title or Position	:	OWNER
Name	:	DR. PRESTON ALEXANDER
Credential	:	M.D.
Telephone Number	:	972-701-9355

Provider Enumeration Date	:	06/19/2015
Last Update Date	:	06/19/2015

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