1891731394 NPI number — DR. KRISTEN G. HOSAKA D.C.

Table of content: HEATHER ELIZABETH OWENS M. ED., CCC-SLP (NPI 1396080230)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891731394 NPI number — DR. KRISTEN G. HOSAKA D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOSAKA
Provider First Name:
KRISTEN
Provider Middle Name:
G.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
O'REILLY
Provider Other First Name:
KRISTEN
Provider Other Middle Name:
G.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.C.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1891731394
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/30/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
250 NW TARRANT ST.
Provider Second Line Business Mailing Address:
SUITE C
Provider Business Mailing Address City Name:
BURLESON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76028-3800
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-426-0676
Provider Business Mailing Address Fax Number:
817-426-0676

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
250 NW TARRANT ST.
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
BURLESON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76028-3800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-426-0676
Provider Business Practice Location Address Fax Number:
817-426-0676
Provider Enumeration Date:
06/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  9527 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 608059 . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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