MEDICARE: QUILL MEDICAL TX

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	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1770475386
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUILL MEDICAL TX

Provider Business Mailing Address
First Line	:	4949 WESTGROVE DR STE 200
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75248-1949
Country	:	US
Telephone Number	:	214-884-7858
Fax Number	:

Provider Business Practice Location Address
First Line	:	4949 WESTGROVE DR STE 200
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75248-1949
Country	:	US
Telephone Number	:	214-884-7858
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KENNETH K ADAMS
Credential	:
Telephone Number	:	214-566-7766

Provider Enumeration Date	:	07/17/2025
Last Update Date	:	12/09/2025

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Directions to “QUILL MEDICAL TX ” Practice Location

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