MEDICARE: RICK L. ANTHONY

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		TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0078NZ	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1659599306
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICK L. ANTHONY

Provider Business Mailing Address
First Line	:	1602 W AVENUE A
Second Line	:	STE# 100
City	:	TEMPLE
State	:	TX
Zip	:	76504-4080
Country	:	US
Telephone Number	:	254-778-6474
Fax Number	:	254-778-6491

Provider Business Practice Location Address
First Line	:	1602 W AVENUE A
Second Line	:	STE# 100
City	:	TEMPLE
State	:	TX
Zip	:	76504-4080
Country	:	US
Telephone Number	:	254-778-6474
Fax Number	:	254-778-6491

Authorized Official
Title or Position	:	OWNER & MANAGER
Name	:	DR. RICK L ANTHONY
Credential	:	DC
Telephone Number	:	254-778-6474

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	03/17/2008

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Directions to “RICK L. ANTHONY ” Practice Location

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