Provider Demographics
NPI:1003001090
Name:EDWARD HAGUE
Entity Type:Organization
Organization Name:EDWARD HAGUE
Other - Org Name:SPINAL REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:HUGH
Authorized Official - Last Name:HAGUE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:940-484-6336
Mailing Address - Street 1:1501 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-3021
Mailing Address - Country:US
Mailing Address - Phone:940-484-8309
Mailing Address - Fax:940-323-8666
Practice Address - Street 1:1501 N ELM ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-3021
Practice Address - Country:US
Practice Address - Phone:940-484-8309
Practice Address - Fax:940-323-8666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10502111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty