Provider Demographics
NPI:1104001049
Name:HOOGEVEEN HEALTH & WELLNESS PA
Entity Type:Organization
Organization Name:HOOGEVEEN HEALTH & WELLNESS PA
Other - Org Name:CHIROCARE OF FRISCO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOOGEVEEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-755-5863
Mailing Address - Street 1:5850 TOWN AND COUNTRY BLVD
Mailing Address - Street 2:SUITE 1301
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6942
Mailing Address - Country:US
Mailing Address - Phone:972-335-7994
Mailing Address - Fax:972-335-7250
Practice Address - Street 1:5850 TOWN AND COUNTRY BLVD
Practice Address - Street 2:SUITE 1301
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6942
Practice Address - Country:US
Practice Address - Phone:972-335-7994
Practice Address - Fax:972-335-7250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9908111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8R8360OtherBCBS PROVIDER # - IND
TX0054MGOtherBCBS PROVIDER # - GROUP
TX1720164791OtherTYPE I NPI - INDIVIDUAL