Healthcare Provider Details

I. General information

NPI: 1881870384
Provider Name (Legal Business Name): HUFFMAN CHIROPRACTIC, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2008
Last Update Date: 01/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 BLUE TAIL DR
HUFFMAN TX
77336-2801
US

IV. Provider business mailing address

319 BLUE TAIL DR
HUFFMAN TX
77336-2801
US

V. Phone/Fax

Practice location:
  • Phone: 832-623-9796
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number8229
License Number StateTX

VIII. Authorized Official

Name: DR. CHARLES BARDWELL
Title or Position: PRESIDENT
Credential: D.C.
Phone: 832-623-9796