MEDICARE: CITY CENTER 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	111N00000X	Chiropractor	8742	TX
2	111N00000X	Chiropractor	11194	TX

General Provider Information

NPI Number	:	1215248919
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY CENTER CHIROPRACTIC

Provider Business Mailing Address
First Line	:	3910 KIRBY DR
Second Line	:	STE 212
City	:	HOUSTON
State	:	TX
Zip	:	77098-4120
Country	:	US
Telephone Number	:	713-522-2886
Fax Number	:	713-522-2738

Provider Business Practice Location Address
First Line	:	3910 KIRBY DR
Second Line	:	STE 212
City	:	HOUSTON
State	:	TX
Zip	:	77098-4120
Country	:	US
Telephone Number	:	713-522-2886
Fax Number	:	713-522-2738

Authorized Official
Title or Position	:	OWNER
Name	:	SARAH HARRILL
Credential	:	DC
Telephone Number	:	713-522-2886

Provider Enumeration Date	:	06/28/2010
Last Update Date	:	06/28/2010

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Directions to “CITY CENTER CHIROPRACTIC ” Practice Location

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