MEDICARE: LOUIE ROBINSON IV 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	12547	TX

General Provider Information

NPI Number	:	1508278805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUIE ROBINSON IV D.C.

Provider Business Mailing Address
First Line	:	1121 BRIARCREST DR STE 100
Second Line	:
City	:	BRYAN
State	:	TX
Zip	:	77802-2500
Country	:	US
Telephone Number	:	979-774-6337
Fax Number	:

Provider Business Practice Location Address
First Line	:	1121 BRIARCREST DR STE 100
Second Line	:
City	:	BRYAN
State	:	TX
Zip	:	77802-2500
Country	:	US
Telephone Number	:	979-774-6337
Fax Number	:

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

Provider Enumeration Date	:	05/21/2014
Last Update Date	:	05/21/2014

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