MEDICARE: DR. KURT ANTHONY JUERGENS D.C.

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	111NS0005X	Sports Physician Chiropractor	4974	TX

General Provider Information

NPI Number	:	1407835093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KURT ANTHONY JUERGENS D.C.

Provider Business Mailing Address
First Line	:	2600 GESSNER DR
Second Line	:	SUITE 140
City	:	HOUSTON
State	:	TX
Zip	:	77080-3839
Country	:	US
Telephone Number	:	713-690-0233
Fax Number	:	713-690-4290

Provider Business Practice Location Address
First Line	:	2600 GESSNER DR
Second Line	:	SUITE 140
City	:	HOUSTON
State	:	TX
Zip	:	77080-3839
Country	:	US
Telephone Number	:	713-690-0233
Fax Number	:	713-690-4290

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

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	07/08/2007

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