Lake Granbury Chiropractic Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4673 Issued in TX

Legal business name

LAKE GRANBURY CHIROPRACTIC CENTER

Practice address

1920 Acton Hwy
Granbury, TX 76049-5988

Phone

(817) 579-0178

Fax

(817) 573-0441

NPI assigned

Feb 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Monte Wayne Hudson, D.C.NPI 1457337198

Title

Chiropractor

Phone

(817) 579-0178

Specialties & licenses 1

Addresses

Other names 1

• Family Chiropractic Assoc., P.C. Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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 Ctr.

  • Chiropractor
  • Granbury, TX
  • NPI 1063497048
  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
  Medicare reassignment 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": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201564800000",
    "number": "1720122807",
    "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 CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2008-01-29",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "MONTE",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "817-579-0178",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "4673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Chiropractic Assoc., P.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• 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 Jan 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.