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General NPI Number Information
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NPI Number | 1003001090
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Entity Type | Organization
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Legal Business Name | EDWARD HAGUE
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Dates
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Enumeration Date | 09/12/2007
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 1501 N ELM ST
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City | DENTON
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State | TX
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Zip | 76201-3021
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Country | US
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Telephone | 940-484-8309
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Fax | 940-323-8666
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Provider Business Mailing Address
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Address Line | 1501 N ELM ST
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City | DENTON
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State | TX
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Zip | 76201-3021
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Country | US
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Telephone | 940-484-8309
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Fax | 940-323-8666
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. EDWARD HUGH HAGUE
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Credential | D.C.
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Telephone | 940-484-6336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 10502
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License Number State | TX
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