Provider Demographics
NPI:1295200228
Name:HOOKED ON HEALTH FAMILY PRACTICE PLLC
Entity Type:Organization
Organization Name:HOOKED ON HEALTH FAMILY PRACTICE PLLC
Other - Org Name:HOOKED ON HEALTH FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JACKLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-550-4198
Mailing Address - Street 1:494 SPRINGHILL ST STE 200
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:TX
Mailing Address - Zip Code:75951-5053
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:494 SPRINGHILL ST STE 200
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TX
Practice Address - Zip Code:75951-5053
Practice Address - Country:US
Practice Address - Phone:409-489-4864
Practice Address - Fax:409-489-4868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-05
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty