Provider Demographics
NPI:1427067313
Name:HOGAN, MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:HOGAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 W MAIN ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-3072
Mailing Address - Country:US
Mailing Address - Phone:469-633-0123
Mailing Address - Fax:469-633-0120
Practice Address - Street 1:8700 W MAIN ST
Practice Address - Street 2:SUITE 130
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-3072
Practice Address - Country:US
Practice Address - Phone:469-633-0123
Practice Address - Fax:469-633-0120
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8896111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8444N0Medicare ID - Type Unspecified