Provider Demographics
NPI:1598984684
Name:DR BRIAN HOOTEN DC PA
Entity Type:Organization
Organization Name:DR BRIAN HOOTEN DC PA
Other - Org Name:HOOTEN FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DR BRIAN HOOTEN D.C
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOOTEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC, BS
Authorized Official - Phone:972-735-9005
Mailing Address - Street 1:15340 DALLAS PKWY
Mailing Address - Street 2:#2740
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-4636
Mailing Address - Country:US
Mailing Address - Phone:972-735-9005
Mailing Address - Fax:972-735-9004
Practice Address - Street 1:15340 DALLAS PKWY
Practice Address - Street 2:#2740
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-4636
Practice Address - Country:US
Practice Address - Phone:972-735-9005
Practice Address - Fax:972-735-9004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8772111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G3165OtherBCBS PROVIDER NUMBER
TXU82676Medicare UPIN
TX8G3165OtherBCBS PROVIDER NUMBER