Provider Demographics
NPI:1821147596
Name:HUDGINS, STEPHEN R II (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:R
Last Name:HUDGINS
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2313 N W MILITARY HWY
Mailing Address - Street 2:SUITE 117
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78231-2532
Mailing Address - Country:US
Mailing Address - Phone:210-525-0096
Mailing Address - Fax:210-525-9760
Practice Address - Street 1:2313 N W MILITARY HWY
Practice Address - Street 2:SUITE 117
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231-2532
Practice Address - Country:US
Practice Address - Phone:210-525-0096
Practice Address - Fax:210-525-9760
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC8254111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8H9167OtherBLUE CROSS/BLUE SHIELD
TX8A6807Medicare PIN