MEDICARE: DR. BLAINE LOREN HENDRICK D.C., F.N.P.-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	10328	TX
2	363LF0000X	Family Nurse Practitioner	796415	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00413186	OTHER	TX	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	8W8690	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1750330445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BLAINE LOREN HENDRICK D.C., F.N.P.-C

Provider Business Mailing Address
First Line	:	5403 N MCCOLL RD
Second Line	:	SUITE A
City	:	MCALLEN
State	:	TX
Zip	:	78504-2206
Country	:	US
Telephone Number	:	956-630-2255
Fax Number	:	956-630-5228

Provider Business Practice Location Address
First Line	:	5403 N MCCOLL RD
Second Line	:	SUITE A
City	:	MCALLEN
State	:	TX
Zip	:	78504-2206
Country	:	US
Telephone Number	:	956-630-2255
Fax Number	:	956-630-5228

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	03/18/2014

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Directions to “ DR. BLAINE LOREN HENDRICK D.C., F.N.P.-C” Practice Location

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