Provider Demographics
NPI:1770728081
Name:HODUM CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:HODUM CHIROPRACTIC, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HODUM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-538-3903
Mailing Address - Street 1:11423 SNYDER DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-8886
Mailing Address - Country:US
Mailing Address - Phone:214-538-3903
Mailing Address - Fax:214-975-1401
Practice Address - Street 1:6951 VIRGINIA PKWY
Practice Address - Street 2:SUITE 320
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5713
Practice Address - Country:US
Practice Address - Phone:214-538-3903
Practice Address - Fax:214-975-1401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-16
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11037111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty