MEDICARE: CENTEX CHIROPRACTIC, LLC

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	13502	TX

General Provider Information

NPI Number	:	1083137244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTEX CHIROPRACTIC, LLC

Provider Business Mailing Address
First Line	:	416 COVENTRY DR
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76502-1972
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2851 N MAIN ST STE 5
Second Line	:
City	:	BELTON
State	:	TX
Zip	:	76513-1109
Country	:	US
Telephone Number	:	337-580-6381
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	JACOB QUINTIN ARNAUD
Credential	:	DC
Telephone Number	:	337-580-6381

Provider Enumeration Date	:	07/19/2017
Last Update Date	:	07/19/2017

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Directions to “CENTEX CHIROPRACTIC, LLC ” Practice Location

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