Provider Demographics
NPI:1922106780
Name:HOLLINGSWORTH, THOMAS RAYMOND III (DC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:RAYMOND
Last Name:HOLLINGSWORTH
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 18963
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78480
Mailing Address - Country:US
Mailing Address - Phone:361-937-9550
Mailing Address - Fax:361-937-4697
Practice Address - Street 1:9450 SPID
Practice Address - Street 2:STE 5
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78418
Practice Address - Country:US
Practice Address - Phone:361-937-9550
Practice Address - Fax:361-937-9550
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9877111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX608107OtherBLUE CROSS BLUE SHIELD
V03237Medicare UPIN
TX608107OtherBLUE CROSS BLUE SHIELD