MEDICARE: DR. SHAWNA KATHLEEN HUDSON D.C.

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	:	1235175050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAWNA KATHLEEN HUDSON D.C.

Provider Business Mailing Address
First Line	:	1209 CORTLANDT ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-7063
Country	:	US
Telephone Number	:	713-862-6008
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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2006
Last Update Date	:	12/16/2008

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