MEDICARE: JASON STARR REHWALD 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	111N00000X	Chiropractor	8853	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	609474	OTHER	TX	MEDICARE OLD PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8X7420	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1467568022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON STARR REHWALD D.C.

Provider Business Mailing Address
First Line	:	1395 E ELDORADO PKWY STE 800
Second Line	:
City	:	LITTLE ELM
State	:	TX
Zip	:	75068-5533
Country	:	US
Telephone Number	:	469-362-0511
Fax Number	:	469-362-0541

Provider Business Practice Location Address
First Line	:	1395 E ELDORADO PKWY STE 800
Second Line	:
City	:	LITTLE ELM
State	:	TX
Zip	:	75068-5533
Country	:	US
Telephone Number	:	469-362-0511
Fax Number	:	469-362-0541

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

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	01/23/2021

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