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Individual
STACY LYLES HAWKINS
Active
Individual
STACY LYLES HAWKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6712
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0096AH
—
TX
01
—
80320B
BCBS
TX
Enumeration date
09/01/2006
Last updated
07/09/2007
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