Provider Demographics
NPI:1073732764
Name:HAGOOD, ROBRET (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBRET
Middle Name:
Last Name:HAGOOD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 W PARMER LN
Mailing Address - Street 2:#112
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-4300
Mailing Address - Country:US
Mailing Address - Phone:512-339-6635
Mailing Address - Fax:512-339-6637
Practice Address - Street 1:2121 W PARMER LN
Practice Address - Street 2:#112
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78727-4300
Practice Address - Country:US
Practice Address - Phone:512-339-6635
Practice Address - Fax:512-339-6637
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7291111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor