Healthcare Provider Details

I. General information

NPI: 1932136504
Provider Name (Legal Business Name): BRIAN E HOOKER ATC/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5835 WYOMING AVE
NEW PORT RICHEY FL
34652-2860
US

IV. Provider business mailing address

5835 WYOMING AVE
NEW PORT RICHEY FL
34652-2860
US

V. Phone/Fax

Practice location:
  • Phone: 727-946-1290
  • Fax:
Mailing address:
  • Phone: 727-946-1290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170100000X
TaxonomyPh.D. Medical Genetics
License NumberAL 286
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: