Provider Demographics
NPI:1497895478
Name:HENSLEY, CHARLES (DC)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:HENSLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13740 N HWY 183
Mailing Address - Street 2:SUITE U-1
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-1841
Mailing Address - Country:US
Mailing Address - Phone:512-335-5426
Mailing Address - Fax:512-335-7462
Practice Address - Street 1:13740 N HWY 183
Practice Address - Street 2:SUITE U-1
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1841
Practice Address - Country:US
Practice Address - Phone:512-335-5426
Practice Address - Fax:512-335-7462
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5388111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU10892Medicare UPIN