Provider Demographics
NPI:1295972156
Name:BRYAN JOHN HAPKA
Entity type:Organization
Organization Name:BRYAN JOHN HAPKA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:HAPKA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:682-237-7212
Mailing Address - Street 1:100 TROPHY CLUB DR
Mailing Address - Street 2:STE. 107
Mailing Address - City:TROPHY CLUB
Mailing Address - State:TX
Mailing Address - Zip Code:76262-3411
Mailing Address - Country:US
Mailing Address - Phone:682-237-7212
Mailing Address - Fax:682-237-7396
Practice Address - Street 1:100 TROPHY CLUB DR
Practice Address - Street 2:STE. 107
Practice Address - City:TROPHY CLUB
Practice Address - State:TX
Practice Address - Zip Code:76262-3411
Practice Address - Country:US
Practice Address - Phone:682-237-7212
Practice Address - Fax:682-237-7396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-14
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11024111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty