Healthcare Provider Details
I. General information
NPI: 1881870087
Provider Name (Legal Business Name): HANUS CHIROPRACTIC CLINIC, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/17/2008
Last Update Date: 01/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
901 N POLK ST SUITE 349
DESOTO TX
75115-4013
US
IV. Provider business mailing address
901 N POLK ST SUITE 349
DESOTO TX
75115-4013
US
V. Phone/Fax
- Phone: 972-224-3344
- Fax: 972-228-4476
- Phone: 972-224-3344
- Fax: 972-228-4476
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | DC4239 |
| License Number State | TX |
VIII. Authorized Official
Name: DR.
STEVEN
WILLIAM
HANUS
Title or Position: PRESIDENT/OWNER
Credential: D.C.
Phone: 972-224-3344