MEDICARE: MICHON HAWKINS, D.C. INC.

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	111NN1001X	Nutrition Chiropractor	6301	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0042HZ	OTHER	TX	BCBS GROUP
2	8G3800	OTHER	TX	BCBS INDIVIDUAL

General Provider Information

NPI Number	:	1871637967
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHON HAWKINS, D.C. INC.

Provider Business Mailing Address
First Line	:	6350 LBJ FREEWAY, STE 166
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-6403
Country	:	US
Telephone Number	:	972-386-9332
Fax Number	:	972-386-0030

Provider Business Practice Location Address
First Line	:	6350 LBJ FREEWAY, STE 166
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-6403
Country	:	US
Telephone Number	:	972-386-9332
Fax Number	:	972-386-0030

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHON M HAWKINS
Credential	:	DC
Telephone Number	:	972-386-9332

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	08/22/2020

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