Provider Demographics
NPI:1124362728
Name:RICHARD W. HARE, D.C.
Entity Type:Organization
Organization Name:RICHARD W. HARE, D.C.
Other - Org Name:SYNERGY SPORTS REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:HARE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-386-2560
Mailing Address - Street 1:13701 DALLAS PKWY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-4335
Mailing Address - Country:US
Mailing Address - Phone:972-386-2560
Mailing Address - Fax:972-349-8108
Practice Address - Street 1:13701 DALLAS PKWY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-4335
Practice Address - Country:US
Practice Address - Phone:972-386-2560
Practice Address - Fax:972-349-8108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-20
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXUB0436Medicare PIN