MEDICARE: JOHN HOPKINS DC

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	111NN0400X	Neurology Chiropractor	DC4853	TX

General Provider Information

NPI Number	:	1235318502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN HOPKINS DC

Provider Business Mailing Address
First Line	:	13601 PRESTON RD STE 315W
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-4946
Country	:	US
Telephone Number	:	972-716-9595
Fax Number	:	972-716-9597

Provider Business Practice Location Address
First Line	:	13601 PRESTON RD
Second Line	:	STE 315W
City	:	DALLAS
State	:	TX
Zip	:	75240-4946
Country	:	US
Telephone Number	:	972-716-9595
Fax Number	:	972-716-9597

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

Provider Enumeration Date	:	11/02/2007
Last Update Date	:	11/02/2007

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