MEDICARE: HOLMES CHIROPRACTIC INC

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	5564	TX

General Provider Information

NPI Number	:	1912233388
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLMES CHIROPRACTIC INC

Provider Business Mailing Address
First Line	:	1235 NORTH LOOP W STE 105
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-1772
Country	:	US
Telephone Number	:	713-862-2440
Fax Number	:	713-880-5193

Provider Business Practice Location Address
First Line	:	1235 NORTH LOOP W STE 105
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-1772
Country	:	US
Telephone Number	:	713-862-2440
Fax Number	:	713-880-5193

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RANDALL HOLMES
Credential	:	DC
Telephone Number	:	713-862-2440

Provider Enumeration Date	:	10/20/2009
Last Update Date	:	10/20/2009

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