Provider Demographics
NPI:1093332157
Name:HASAN, MUSA S (DC)
Entity Type:Individual
Prefix:
First Name:MUSA
Middle Name:S
Last Name:HASAN
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 1:601 SE MELODY LN
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063-4804
Mailing Address - Country:US
Mailing Address - Phone:214-265-9000
Mailing Address - Fax:214-696-1757
Practice Address - Street 1:800 8TH AVE STE 114
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2606
Practice Address - Country:US
Practice Address - Phone:817-367-9981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14357111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor