Dr Jimmy Brian Sullivan, DC | |
1540 Rice Rd Ste 400, Tyler, TX 75703-3223 | |
(903) 597-9021 | |
Not Available |
Full Name | Dr Jimmy Brian Sullivan |
---|---|
Gender | Male |
Speciality | Chiropractic |
Experience | 11 Years |
Location | 1540 Rice Rd Ste 400, Tyler, Texas |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619368941 | NPI | - | NPPES |
583300AC3Z | Other | TX | MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 12808 (Texas) | Primary |
Provider Name | Four-ten Enterprise, Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1619497401 PECOS PAC ID: 0345510574 Enrollment ID: O20170721000320 |
Mailing Address | Practice Location Address |
---|---|
Dr Jimmy Brian Sullivan, DC 1540 Rice Rd Ste 400, Tyler, TX 75703-3223 Ph: (903) 597-9021 | Dr Jimmy Brian Sullivan, DC 1540 Rice Rd Ste 400, Tyler, TX 75703-3223 Ph: (903) 597-9021 |
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