Provider Demographics
NPI:1891731394
Name:HOSAKA, KRISTEN G (DC)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:G
Last Name:HOSAKA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:G
Other - Last Name:O'REILLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:250 NW TARRANT ST.
Mailing Address - Street 2:SUITE C
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-3800
Mailing Address - Country:US
Mailing Address - Phone:817-426-0676
Mailing Address - Fax:817-426-0676
Practice Address - Street 1:250 NW TARRANT ST.
Practice Address - Street 2:SUITE C
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-3800
Practice Address - Country:US
Practice Address - Phone:817-426-0676
Practice Address - Fax:817-426-0676
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9527111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX608059OtherBCBS
TX613002Medicare PIN
TX608059OtherBCBS