Provider Demographics
NPI:1821501149
Name:HERNANDEZ & WOOLDRIDGE, LLC
Entity Type:Organization
Organization Name:HERNANDEZ & WOOLDRIDGE, LLC
Other - Org Name:KYLE FAMILY & INJURY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-268-2273
Mailing Address - Street 1:102 S MEYER ST
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-5686
Mailing Address - Country:US
Mailing Address - Phone:512-268-2273
Mailing Address - Fax:800-807-8174
Practice Address - Street 1:102 S MEYER ST
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-5686
Practice Address - Country:US
Practice Address - Phone:512-268-2273
Practice Address - Fax:800-807-8174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-08
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13136111N00000X
TX13312111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1063922243OtherNPI
TX1609237213OtherNPI