Provider Demographics
NPI:1326466046
Name:HENDRICKS CHIROPRACTIC, P.A.
Entity Type:Organization
Organization Name:HENDRICKS CHIROPRACTIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:B
Authorized Official - Last Name:HENDRICKS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:903-597-5000
Mailing Address - Street 1:1213 DOCTORS DR.
Mailing Address - Street 2:HENDRICKS CHIROPRACTIC P.A.
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701
Mailing Address - Country:US
Mailing Address - Phone:903-597-5000
Mailing Address - Fax:903-596-9402
Practice Address - Street 1:1213 DOCTORS DR.
Practice Address - Street 2:HENDRICKS CHIROPRACTIC P.A.
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701
Practice Address - Country:US
Practice Address - Phone:903-597-5000
Practice Address - Fax:903-596-9402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-31
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4587111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty