MEDICARE: SYKES CHIROPRACTIC PLLC

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	11678	TX

General Provider Information

NPI Number	:	1811287535
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYKES CHIROPRACTIC PLLC

Provider Business Mailing Address
First Line	:	7633 BELLAIRE DR S STE 101
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-4311
Country	:	US
Telephone Number	:	817-349-7541
Fax Number	:	817-349-7549

Provider Business Practice Location Address
First Line	:	7633 BELLAIRE DR S STE 101
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-4311
Country	:	US
Telephone Number	:	817-349-7541
Fax Number	:	817-349-7549

Authorized Official
Title or Position	:	OWNER/CHIROPRACTOR
Name	:	DR. KEVIN CARSTEN SYKES
Credential	:	D.C.
Telephone Number	:	817-349-7541

Provider Enumeration Date	:	04/14/2011
Last Update Date	:	12/18/2015

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