MEDICARE: SOMATIC CHIROPRACTIC, PA

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	8863	TX

General Provider Information

NPI Number	:	1326156597
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOMATIC CHIROPRACTIC, PA

Provider Business Mailing Address
First Line	:	4607 REFUGIO RD
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75034-8495
Country	:	US
Telephone Number	:	972-930-9566
Fax Number	:	972-930-9710

Provider Business Practice Location Address
First Line	:	7517 CAMPBELL RD STE 606
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75248-1762
Country	:	US
Telephone Number	:	972-930-9566
Fax Number	:	972-930-9710

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MITCHELL SHUCHMAN ADAM SHUCHMAN
Credential	:	DC
Telephone Number	:	972-930-9566

Provider Enumeration Date	:	08/28/2006
Last Update Date	:	08/22/2020

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