Individual
DR. JACOB C HAMBLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
4560 LAKE RIDGE PKWY STE 200, GRAND PRAIRIE, TX 75052-1706
(800) 404-6050
(866) 313-3397
Mailing address
PO BOX 700688, SAN ANTONIO, TX 78270-0688
(210) 477-7654
(210) 468-0682
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
13812
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13812
TEXAS BOARD OF CHIROPRACTIC EXAMINERS
TX
Enumeration date
07/10/2018
Last updated
07/10/2019
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