MEDICARE: MICHAEL BANDY 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	6519	TX

General Provider Information

NPI Number	:	1235375627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL BANDY D.C.

Provider Business Mailing Address
First Line	:	2700 W ANDERSON LN STE 204
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78757-1153
Country	:	US
Telephone Number	:	512-904-0914
Fax Number	:	512-454-8846

Provider Business Practice Location Address
First Line	:	2700 W ANDERSON LN STE 204
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78757-1153
Country	:	US
Telephone Number	:	512-904-0914
Fax Number	:	512-454-8846

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

Provider Enumeration Date	:	01/06/2009
Last Update Date	:	09/24/2010

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