MEDICARE: DR. CHRISTOPHER ISAIAH BEARD 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	15094	TX

General Provider Information

NPI Number	:	1619623493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER ISAIAH BEARD DC

Provider Business Mailing Address
First Line	:	10300 JOLLYVILLE RD APT 535
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-5677
Country	:	US
Telephone Number	:	915-203-6382
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 S IH 35 STE L725
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78748-1769
Country	:	US
Telephone Number	:	512-540-3985
Fax Number	:

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

Provider Enumeration Date	:	03/01/2022
Last Update Date	:	03/01/2022

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