MEDICARE: UPTOWN 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	DC6954	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8K6050	OTHER	TX	BC BS OF TEXAS

General Provider Information

NPI Number	:	1275718579
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UPTOWN CHIROPRACTIC

Provider Business Mailing Address
First Line	:	2909 COLE AVE
Second Line	:	STE 205
City	:	DALLAS
State	:	TX
Zip	:	75204-1189
Country	:	US
Telephone Number	:	214-979-9013
Fax Number	:	214-979-9014

Provider Business Practice Location Address
First Line	:	2909 COLE AVE
Second Line	:	STE 205
City	:	DALLAS
State	:	TX
Zip	:	75204-1189
Country	:	US
Telephone Number	:	214-979-9013
Fax Number	:	214-979-9014

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LYNNE AUERBACH
Credential	:	DC
Telephone Number	:	214-979-9013

Provider Enumeration Date	:	01/04/2008
Last Update Date	:	01/04/2008

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Directions to “UPTOWN CHIROPRACTIC ” Practice Location

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