MEDICARE: DR. KYSKA DAWN SPURLOCK 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	11741	TX

General Provider Information

NPI Number	:	1114280336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KYSKA DAWN SPURLOCK D.C.

Provider Business Mailing Address
First Line	:	8617 MID CITIES BOULEVARD
Second Line	:	SUITE 200
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76182
Country	:	US
Telephone Number	:	682-551-4333
Fax Number	:

Provider Business Practice Location Address
First Line	:	8617 MID CITIES BOULEVARD
Second Line	:	SUITE 200
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76182
Country	:	US
Telephone Number	:	682-551-4333
Fax Number	:

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

Provider Enumeration Date	:	06/21/2012
Last Update Date	:	05/24/2016

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