MEDICARE: MR. JOSEPH ARTHUR REILLY JR. 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	2900	TX

General Provider Information

NPI Number	:	1780736967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSEPH ARTHUR REILLY JR. DC

Provider Business Mailing Address
First Line	:	17707 HIDDEN FOREST DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-8765
Country	:	US
Telephone Number	:	713-524-0966
Fax Number	:	713-524-1204

Provider Business Practice Location Address
First Line	:	3415 LOUISIANA ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002-9523
Country	:	US
Telephone Number	:	713-524-0966
Fax Number	:	713-524-1204

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

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	07/09/2007

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