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NPI Code Detail

MEDICARE: DCMDPA

MEDICARE: DCMDPA
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
1111N00000XChiropractor8704TX

General Provider Information

NPI Number : 1700073137
Entity Type Code : Organization
Provider Name (Legal Business Name) : DCMDPA
Provider Business Mailing Address
First Line : 2306 S BUCKNER BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75227-8605
Country : US
Telephone Number : 214-275-4124
Fax Number : 214-275-4408
Provider Business Practice Location Address
First Line : 2306 S BUCKNER BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75227-8605
Country : US
Telephone Number : 214-275-4124
Fax Number : 214-275-4408
Authorized Official
Title or Position : CHIROPRACTOR
Name : SEAN C KILGORE
Credential : D.C.
Telephone Number : 214-275-4124
Provider Enumeration Date : 10/01/2007
Last Update Date : 10/01/2007

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Directions to “DCMDPA ” Practice Location

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