Provider Demographics
NPI:1497757900
Name:HAWKINS, HOWARD WAYNE JR (DC)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:WAYNE
Last Name:HAWKINS
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:WAYNE
Other - Middle Name:
Other - Last Name:HAWKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:322 W. MAIN
Mailing Address - Street 2:SUITE 103
Mailing Address - City:KENEDY
Mailing Address - State:TX
Mailing Address - Zip Code:78119-2798
Mailing Address - Country:US
Mailing Address - Phone:830-583-8045
Mailing Address - Fax:361-356-3975
Practice Address - Street 1:322 W MAIN ST
Practice Address - Street 2:SUITE 103
Practice Address - City:KENEDY
Practice Address - State:TX
Practice Address - Zip Code:78119-2740
Practice Address - Country:US
Practice Address - Phone:830-583-8045
Practice Address - Fax:361-356-3975
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2016-01-21
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-03-28
Provider Licenses
StateLicense IDTaxonomies
TX9414111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU93593Medicare UPIN
TX606409OtherBCBS
TX609784Medicare ID - Type Unspecified