MEDICARE: HIMMELSEHR CHIROPRACTIC

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	111NS0005X	Sports Physician Chiropractor	8299	TX

General Provider Information

NPI Number	:	1144527631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIMMELSEHR CHIROPRACTIC

Provider Business Mailing Address
First Line	:	1530 FOREST LN S
Second Line	:	SUITE H
City	:	GARLAND
State	:	TX
Zip	:	75042-7950
Country	:	US
Telephone Number	:	972-272-8769
Fax Number	:	972-272-8920

Provider Business Practice Location Address
First Line	:	1530 FOREST LN S
Second Line	:	SUITE H
City	:	GARLAND
State	:	TX
Zip	:	75042-7950
Country	:	US
Telephone Number	:	972-272-8769
Fax Number	:	972-272-8920

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CRAIG HIMMELSEHR
Credential	:	D.C.
Telephone Number	:	972-272-8769

Provider Enumeration Date	:	02/17/2011
Last Update Date	:	02/17/2011

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Directions to “HIMMELSEHR CHIROPRACTIC ” Practice Location

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