Provider Demographics
NPI:1558528588
Name:HUBERT, J. CHRIS (DC)
Entity Type:Individual
Prefix:DR
First Name:J. CHRIS
Middle Name:
Last Name:HUBERT
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 1:1400 WSW LOOP 323 STE 60
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-7059
Mailing Address - Country:US
Mailing Address - Phone:903-526-4875
Mailing Address - Fax:903-526-4876
Practice Address - Street 1:1400 W SOUTHWEST LOOP 323 STE 60
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-7059
Practice Address - Country:US
Practice Address - Phone:903-526-4875
Practice Address - Fax:903-526-4876
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10896111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor