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Individual
LACI D HENDRICKS
Active
Individual
LACI D HENDRICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
31044
CA
111N00000X
Chiropractor
6551
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000605653
BCBS OF TEXAS
TX
01
—
0005101694
AETNA
TX
01
—
001119290
APWU
TX
05
—
001989501
—
TX
01
—
C 605653
UNITED AMERICAN INS CO
TX
01
—
P00207317
PALMETTO GBA
TX
Enumeration date
09/20/2006
Last updated
05/03/2012
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