Provider Demographics
NPI:1568561991
Name:HOOD CHIROPRACTIC & WELLNESS CENTER PC
Entity Type:Organization
Organization Name:HOOD CHIROPRACTIC & WELLNESS CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:KELLY
Authorized Official - Last Name:HOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:903-894-4599
Mailing Address - Street 1:PO BOX 3004
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:TX
Mailing Address - Zip Code:75762-3050
Mailing Address - Country:US
Mailing Address - Phone:903-894-4599
Mailing Address - Fax:903-894-5150
Practice Address - Street 1:10678 FM 346 WEST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:TX
Practice Address - Zip Code:75762-8745
Practice Address - Country:US
Practice Address - Phone:903-894-4599
Practice Address - Fax:903-894-5150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC4246111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX350019060OtherRAILROAD MEDICARE
TX1613135-01Medicaid
TX8R2020OtherBLUE CROSS BLUE SHIELD
TX8R2020OtherBLUE CROSS BLUE SHIELD
TX8D0843Medicare ID - Type Unspecified