Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2626 | TX |
NPI | 1003880543 |
---|---|
Provider Name | Dr. Walter Joseph Hart III |
First Address | Dallas, TX 75252-4026 |
Second Address | Dallas, TX 75252-4026 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2006 |
Last Update Date | 08/07/2007 |