MEDICARE: DR. MARK EDWARD PLUMMER 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	5109	TX

General Provider Information

NPI Number	:	1598867327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK EDWARD PLUMMER D.C.

Provider Business Mailing Address
First Line	:	2646 SOUTH LOOP W
Second Line	:	#650
City	:	HOUSTON
State	:	TX
Zip	:	77054-2665
Country	:	US
Telephone Number	:	713-838-8600
Fax Number	:	713-838-8488

Provider Business Practice Location Address
First Line	:	2646 SOUTH LOOP W
Second Line	:	#650
City	:	HOUSTON
State	:	TX
Zip	:	77054-2665
Country	:	US
Telephone Number	:	713-838-8600
Fax Number	:	713-838-8488

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

Provider Enumeration Date	:	09/02/2006
Last Update Date	:	07/08/2007

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