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NPI Code Detail

MEDICARE: DR. JASON LAURELES DC

MEDICARE: DR. JASON LAURELES 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
1111N00000XChiropractor15196TX

General Provider Information

NPI Number : 1821735119
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JASON LAURELES DC
Provider Business Mailing Address
First Line : 9170 CYPRESS WATERS BLVD APT 114
Second Line :
City : COPPELL
State : TX
Zip : 75019-4895
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 600 E JOHN CARPENTER FWY STE 125
Second Line :
City : IRVING
State : TX
Zip : 75062-4299
Country : US
Telephone Number : 972-556-5667
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2022
Last Update Date : 05/18/2022

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Directions to “ DR. JASON LAURELES DC” Practice Location

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