MEDICARE: STAR CHIRO, LLC

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

General Provider Information

NPI Number	:	1679138234
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STAR CHIRO, LLC

Provider Business Mailing Address
First Line	:	3305 LONG PRAIRIE RD STE 120
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75022-2775
Country	:	US
Telephone Number	:	972-472-0002
Fax Number	:

Provider Business Practice Location Address
First Line	:	3305 LONG PRAIRIE RD STE 120
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75022-2775
Country	:	US
Telephone Number	:	972-472-0002
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR OF CHIROPRACTIC
Name	:	DR. ADAM WAYNE WILLIAMS
Credential	:	DC
Telephone Number	:	972-472-0002

Provider Enumeration Date	:	05/08/2019
Last Update Date	:	05/08/2019

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Directions to “STAR CHIRO, LLC ” Practice Location

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