MEDICARE: HULEN CHIROPRACTIC CLINIC PLLC

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	8437	TX

General Provider Information

NPI Number	:	1295011336
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HULEN CHIROPRACTIC CLINIC PLLC

Provider Business Mailing Address
First Line	:	7315 S HULEN ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-6616
Country	:	US
Telephone Number	:	817-346-0453
Fax Number	:	817-346-0967

Provider Business Practice Location Address
First Line	:	7315 S HULEN ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-6616
Country	:	US
Telephone Number	:	817-346-0453
Fax Number	:	817-346-0967

Authorized Official
Title or Position	:	OWNER / PROVIDER
Name	:	DR. BRYAN G CARTER
Credential	:	DC
Telephone Number	:	830-238-4112

Provider Enumeration Date	:	11/02/2011
Last Update Date	:	01/18/2012

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