Organization
HEBERT SOUTHLAKE CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES WAYNE HEBERT DC (OWNER)
(817) 488-8837
Entity
Organization
Contact information
Practice address
170 PLAYERS CIRCLE, #100, SOUTHLAKE, TX 76092-6943
(817) 488-8837
(817) 488-8837
Mailing address
170 PLAYERS CIRCLE, #100, SOUTHLAKE, TX 76092
(817) 488-8837
(817) 488-8927
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
4244
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0040PD
BLUECROSS BLUESHIELD
TX
01
—
111N00000X
TAXONOMIES
TX
01
—
4632699
AETNA
TX
Enumeration date
04/24/2007
Last updated
04/20/2008
Update your record
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