Lake Granbury Chiropractic Ctr.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4673 Issued in TX

Legal business name

LAKE GRANBURY CHIROPRACTIC CTR.

Doing business as

FAMILY CHIROPRACTIC ASSO., P.C.

Practice address

1920 Acton Hwy
Granbury, TX 76049-5988

Phone

(817) 579-0178

Fax

(817) 573-0441

NPI assigned

Dec 13, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Monte Wayne Hudson, D.C.NPI 1457337198

Title

President

Phone

(817) 579-0178

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• FAMILY CHIROPRACTIC ASSO., P.C. Doing business as

Tax ID family

Lake Granbury Chiropractic Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lake Granbury Chiropractic Center

  • Chiropractor
  • Granbury, TX
  • NPI 1720122807
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Monte Wayne Hudson, D.C.

  • Chiropractor
  • Granbury, TX
  • NPI 1457337198
  NPD Authorized official
• Steven M Thomas, D.C.

  • Chiropractor
  • Stephenville, TX
  • NPI 1073513073
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063497048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 ACTON HWY",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760495988",
            "telephone_number": "817-579-0178",
            "fax_number": "817-573-0441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 ACTON HWY",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760495988",
            "telephone_number": "817-579-0178",
            "fax_number": "817-573-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE GRANBURY CHIROPRACTIC CTR.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "MONTE",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-579-0178",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "4673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z00H63E8",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY CHIROPRACTIC ASSO., P.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andre Alexander Kulisz, PHD, ND, ACN
• Lisa Annette Kutas, OT
• Kyle W Rogers DDS Inc
• Laboratory Corporation of America
• Lake Granbury Chiropractic Center
• Lake Granbury Dental & Orthodontics PLLC
• Lake Granbury HB Medical Services LLC
• Lake Granbury Hospital-Based Professional Services
• Lake Granbury Internal Medicine & Pediatrics, PA
• Lake Pointe Resource Center, Inc.

• Chiropractor in Granbury, TX
• Providers in Granbury, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.