MEDICARE: RICHARD W. HARE, 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		TX

General Provider Information

NPI Number	:	1124362728
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD W. HARE, D.C.

Provider Business Mailing Address
First Line	:	13701 DALLAS PKWY
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-4335
Country	:	US
Telephone Number	:	972-386-2560
Fax Number	:	972-349-8108

Provider Business Practice Location Address
First Line	:	13701 DALLAS PKWY
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-4335
Country	:	US
Telephone Number	:	972-386-2560
Fax Number	:	972-349-8108

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RICHARD W HARE
Credential	:	D.C.
Telephone Number	:	972-386-2560

Provider Enumeration Date	:	11/20/2012
Last Update Date	:	11/20/2012

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