MEDICARE: HUDSON CHIROPRACTIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	7149DC	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003910530
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUDSON CHIROPRACTIC

Provider Business Mailing Address
First Line	:	1820-1 W 43RD ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-3006
Country	:	US
Telephone Number	:	713-290-1905
Fax Number	:	713-290-8322

Provider Business Practice Location Address
First Line	:	1820-1 W 43RD ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-3006
Country	:	US
Telephone Number	:	713-290-1905
Fax Number	:	713-290-8322

Authorized Official
Title or Position	:	CHIRPRACTOR/OWNER
Name	:	DR. SHAWNA KATHLEEN HUDSON
Credential	:	D.C.
Telephone Number	:	713-290-1905

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	12/16/2008

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Directions to “HUDSON CHIROPRACTIC ” Practice Location

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