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General NPI Number Information
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NPI Number | 1366792723
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Entity Type | Organization
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Legal Business Name | TETSUYA HASEGAWA, D.C., INC.
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Dates
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Enumeration Date | 09/13/2012
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Last Update Date | 09/13/2012
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Provider Practice Location Address
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Address Line | 1221 ARISTA ROAD SUITE 150
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City | ROCKWALL
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State | TX
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Zip | 75032
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Country | US
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Telephone | 214-797-6560
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Fax |
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Provider Business Mailing Address
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Address Line | 1221 ARISTA ROAD SUITE 150
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City | ROCKWALL
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State | TX
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Zip | 75032
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Country | US
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Telephone | 214-797-6560
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. TETSUYA HASEGAWA
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Credential | D.C.
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Telephone | 214-797-6560
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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 | 10874
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License Number State | TX
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