Healthcare Provider Details

I. General information

NPI: 1689635336
Provider Name (Legal Business Name): HAO-CHIEH (JACK) HUANG D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 04/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 W 15TH ST; SUITE 103
PLANO TX
75093-5826
US

IV. Provider business mailing address

4100 W 15TH ST
PLANO TX
75093-5826
US

V. Phone/Fax

Practice location:
  • Phone: 972-312-8000
  • Fax: 972-312-8028
Mailing address:
  • Phone: 972-312-8000
  • Fax: 972-312-8028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number9233
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: