Provider Demographics
NPI:1245503846
Name:SCOTT KERR ENTERPRISES
Entity type:Organization
Organization Name:SCOTT KERR ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:D
Authorized Official - Last Name:KERR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:409-962-3123
Mailing Address - Street 1:2401 JEFFERSON DR
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-1805
Mailing Address - Country:US
Mailing Address - Phone:409-962-3123
Mailing Address - Fax:409-962-3249
Practice Address - Street 1:2401 JEFFERSON DR
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-1805
Practice Address - Country:US
Practice Address - Phone:409-962-3123
Practice Address - Fax:409-962-3249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-14
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC4250111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1467569806OtherINDIVIDUAL NPI
TX306015868Medicaid
TXOTH000Medicare UPIN
TX601586Medicare Oscar/Certification