Provider Demographics
NPI:1285930156
Name:HIX, CHARLES VINSON (DC)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:VINSON
Last Name:HIX
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 1:2202 TUSCAN LN
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77520-3535
Mailing Address - Country:US
Mailing Address - Phone:281-515-0933
Mailing Address - Fax:
Practice Address - Street 1:2202 TUSCAN LN
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-3535
Practice Address - Country:US
Practice Address - Phone:281-515-0933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX8700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor