Provider Demographics
NPI:1164540670
Name:HEGEL, SUE ELLEN HOSACK (DC)
Entity Type:Individual
Prefix:DR
First Name:SUE ELLEN
Middle Name:HOSACK
Last Name:HEGEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6150 INDEPENDENCE PKWY
Mailing Address - Street 2:SUITE K
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-4000
Mailing Address - Country:US
Mailing Address - Phone:214-235-8373
Mailing Address - Fax:
Practice Address - Street 1:6150 INDEPENDENCE PKWY
Practice Address - Street 2:SUITE K
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-4000
Practice Address - Country:US
Practice Address - Phone:214-235-8373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9925111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A7712OtherBLUE CROSS BLUE SHIELD