Provider Demographics
NPI:1295923134
Name:HOGAN CHIROPRACTIC
Entity type:Organization
Organization Name:HOGAN CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-402-0440
Mailing Address - Street 1:12400 W HIGHWAY 71
Mailing Address - Street 2:SUITE 240
Mailing Address - City:BEE CAVE
Mailing Address - State:TX
Mailing Address - Zip Code:78738-6517
Mailing Address - Country:US
Mailing Address - Phone:512-402-0440
Mailing Address - Fax:512-402-0141
Practice Address - Street 1:12400 W HIGHWAY 71
Practice Address - Street 2:SUITE 240
Practice Address - City:BEE CAVE
Practice Address - State:TX
Practice Address - Zip Code:78738-6517
Practice Address - Country:US
Practice Address - Phone:512-402-0440
Practice Address - Fax:512-402-0141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00301WMedicare PIN