MEDICARE: CASEY SANDERS 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	111N00000X	Chiropractor	13397	TX

General Provider Information

NPI Number	:	1326811324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASEY SANDERS DC

Provider Business Mailing Address
First Line	:	7942 SALMON RUN WAY
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76137-5692
Country	:	US
Telephone Number	:	817-944-4409
Fax Number	:

Provider Business Practice Location Address
First Line	:	4712 BOAT CLUB RD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76135-2002
Country	:	US
Telephone Number	:	817-944-4409
Fax Number	:

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

Provider Enumeration Date	:	11/01/2023
Last Update Date	:	11/01/2023

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Directions to “ CASEY SANDERS DC” Practice Location

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