Provider Demographics
NPI:1437263142
Name:DUCHON, CHAD (D C)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:
Last Name:DUCHON
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4926 S GLEN LN
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-6285
Mailing Address - Country:US
Mailing Address - Phone:281-554-6855
Mailing Address - Fax:
Practice Address - Street 1:2724 61ST ST STE 5
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77551-1800
Practice Address - Country:US
Practice Address - Phone:409-744-9355
Practice Address - Fax:409-744-9356
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8210111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F2798Medicare ID - Type Unspecified
TXU74378Medicare UPIN