Hagebusch, Marc E

Hagebusch, Marc E is an individual health care provider with primary practice located at 3801 N State Line Ave , Texarkana TX 75503-3132. He recently has only one registered license in Chiropractic Providers / Orthopedic, which is considered as his primary health care specialty. Hagebusch, Marc E can be contacted via phone (903) 792-3763.

Contact Information

Primary practice address
3801 N State Line Ave Texarkana TX 75503-3132
Phone: (903) 792-3763
Fax: (903) 792-6898
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Orthopedic 111NX0800X 7000 Texas

Profile Details

NPI number 1922006964
LBN Legal business name Hagebusch, Marc E
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2005
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922006964 NPPES
Texas MEDICAID PO89Y5638
Texas Other 91929
Texas Other 89Y563
Texas Other 98206
Texas MEDICAID 91929

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