Provider Demographics
NPI:1528896875
Name:HEALTHSOURCE OF LEWISVILLE PLLC
Entity type:Organization
Organization Name:HEALTHSOURCE OF LEWISVILLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-315-3576
Mailing Address - Street 1:475 STATE HIGHWAY 121 BYP STE 100
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-8178
Mailing Address - Country:US
Mailing Address - Phone:972-315-3576
Mailing Address - Fax:
Practice Address - Street 1:475 STATE HIGHWAY 121 BYP STE 100
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-8178
Practice Address - Country:US
Practice Address - Phone:972-315-3576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty