MEDICARE: DIRK W HUNTER 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	7862	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7862	OTHER	TX	TEXAS STATE LICENSE

General Provider Information

NPI Number	:	1336308352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIRK W HUNTER DC

Provider Business Mailing Address
First Line	:	4826 WASHINGTON AVENUE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-5304
Country	:	US
Telephone Number	:	713-802-2739
Fax Number	:	713-802-9680

Provider Business Practice Location Address
First Line	:	4826 WASHINGTON AVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-5304
Country	:	US
Telephone Number	:	713-802-2739
Fax Number	:	713-802-9680

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

Provider Enumeration Date	:	06/05/2008
Last Update Date	:	06/05/2008

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Directions to “ DIRK W HUNTER DC” Practice Location

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