Provider Demographics
NPI:1588022750
Name:HANCOCK FAMILY CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:HANCOCK FAMILY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:HANCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-528-9177
Mailing Address - Street 1:3930 LOUETTA RD
Mailing Address - Street 2:STE A
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388
Mailing Address - Country:US
Mailing Address - Phone:281-528-9177
Mailing Address - Fax:281-528-9545
Practice Address - Street 1:3930 LOUETTA RD
Practice Address - Street 2:STE A
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-4565
Practice Address - Country:US
Practice Address - Phone:281-528-9177
Practice Address - Fax:281-528-9545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-03
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8353111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX361933Medicare UPIN