MEDICARE: DR. STEVEN MICHAEL CARRELL JR. 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	12434	TX

General Provider Information

NPI Number	:	1154750594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN MICHAEL CARRELL JR. D.C.

Provider Business Mailing Address
First Line	:	207 FLOWERS ST
Second Line	:
City	:	DAYTON
State	:	TX
Zip	:	77535-2216
Country	:	US
Telephone Number	:	713-213-2693
Fax Number	:

Provider Business Practice Location Address
First Line	:	9855B EAGLE DRIVE
Second Line	:	SUITE 130
City	:	MONT BELVIEU
State	:	TX
Zip	:	77523
Country	:	US
Telephone Number	:	713-213-2693
Fax Number	:

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

Provider Enumeration Date	:	11/06/2013
Last Update Date	:	06/03/2020

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