Provider Demographics
NPI:1730335183
Name:WHITEHEAD, HUNT N (DC)
Entity type:Individual
Prefix:DR
First Name:HUNT
Middle Name:N
Last Name:WHITEHEAD
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 1:8821 DAVIS BLVD, BLDG 3, STE.320
Mailing Address - Street 2:8821 DAVIS BLVD, BLDG 3, STE., 320
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248
Mailing Address - Country:US
Mailing Address - Phone:817-223-6566
Mailing Address - Fax:817-424-5806
Practice Address - Street 1:500 W SOUTHLAKE BLVD
Practice Address - Street 2:STE 134
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6165
Practice Address - Country:US
Practice Address - Phone:817-424-4044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-15
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7356111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor