Provider Demographics
NPI:1932306107
Name:SAMMY HARDIN DC PA
Entity Type:Organization
Organization Name:SAMMY HARDIN DC PA
Other - Org Name:SAMMY HARDIN DC PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMMY
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:HARDIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-548-2225
Mailing Address - Street 1:2001 CENTRAL CIR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-8202
Mailing Address - Country:US
Mailing Address - Phone:972-548-2225
Mailing Address - Fax:972-548-9662
Practice Address - Street 1:2001 CENTRAL CIR
Practice Address - Street 2:SUITE 108
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-8202
Practice Address - Country:US
Practice Address - Phone:972-548-2225
Practice Address - Fax:972-548-9662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9109111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX606333OtherBCBS #
TX=========OtherTAX ID NUMBER
TX00938TMedicare PIN