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Individual

DR. LYLE MARTIN HODGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
223 W WINTERGREEN RD, DUNCANVILLE, TX 75137-4423
(469) 323-7322
Mailing address
223 W WINTERGREEN RD, DUNCANVILLE, TX 75137-4423
(469) 323-7322

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
3029
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0012650-01
TX
Enumeration date
03/26/2007
Last updated
05/01/2020
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