MEDICARE: DR. SHANALY RAMIREZ RODRIGUEZ 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	14603	TX

General Provider Information

NPI Number	:	1649867391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHANALY RAMIREZ RODRIGUEZ DC

Provider Business Mailing Address
First Line	:	400 S ZANG BLVD STE 1210
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75208-6624
Country	:	US
Telephone Number	:	972-232-2227
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 S ZANG BLVD STE 1210
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75208-6624
Country	:	US
Telephone Number	:	972-232-2227
Fax Number	:

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

Provider Enumeration Date	:	12/29/2020
Last Update Date	:	12/29/2020

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Directions to “ DR. SHANALY RAMIREZ RODRIGUEZ DC” Practice Location

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