Provider Demographics
NPI:1457449332
Name:HASSEBROCK, BRENDA (DC)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:
Last Name:HASSEBROCK
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 1:9099 WESTHEIMER RD STE I
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-3620
Mailing Address - Country:US
Mailing Address - Phone:713-780-8343
Mailing Address - Fax:713-780-8378
Practice Address - Street 1:9099 WESTHEIMER RD STE I
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-3620
Practice Address - Country:US
Practice Address - Phone:713-780-8343
Practice Address - Fax:713-780-8378
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5263111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX603144Medicare PIN