Healthcare Provider Details

I. General information

NPI: 1952009946
Provider Name (Legal Business Name): MR. SATYA VIVEK HARDIKER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2023
Last Update Date: 02/20/2023
Certification Date: 02/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4040 LEGACY DR STE 203
FRISCO TX
75034-6748
US

IV. Provider business mailing address

4040 LEGACY DR STE 203
FRISCO TX
75034-6748
US

V. Phone/Fax

Practice location:
  • Phone: 214-437-0133
  • Fax: 214-377-6243
Mailing address:
  • Phone: 214-437-0133
  • Fax: 214-377-6243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number15529
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: