MEDICARE: DR. MARY KAY EBEIER EBEIER OSBORN DC DOCTOR OF CHIROPR

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	6134	TX

General Provider Information

NPI Number	:	1093926719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY KAY EBEIER EBEIER OSBORN DC DOCTOR OF CHIROPR

Provider Business Mailing Address
First Line	:	4407 BEE CAVE RD
Second Line	:	#4-412
City	:	AUSTIN
State	:	TX
Zip	:	78746-6405
Country	:	US
Telephone Number	:	512-327-6101
Fax Number	:	512-367-2929

Provider Business Practice Location Address
First Line	:	4407 BEE CAVE RD
Second Line	:	#4-412
City	:	AUSTIN
State	:	TX
Zip	:	78746-6405
Country	:	US
Telephone Number	:	512-327-6101
Fax Number	:	512-367-2929

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

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	07/08/2007

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