MEDICARE: DR. BRYAN GREGORY CARTER 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	8437	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932105418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRYAN GREGORY CARTER DC

Provider Business Mailing Address
First Line	:	7315 S HULEN ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-6616
Country	:	US
Telephone Number	:	817-346-0453
Fax Number	:	817-346-0967

Provider Business Practice Location Address
First Line	:	7315 S HULEN ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-6616
Country	:	US
Telephone Number	:	817-346-0453
Fax Number	:	817-346-0967

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

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	06/21/2016

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