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General NPI Number Information
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NPI Number | 1679731392
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Entity Type | Organization
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Legal Business Name | TEXAS INDEPENDENT EVALUATORS
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Dates
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Enumeration Date | 05/29/2008
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Last Update Date | 05/29/2008
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Provider Practice Location Address
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Address Line | 170 PLAYERS CIR SUITE 100
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6942
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Country | US
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Telephone | 682-553-7800
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Fax | 817-488-8973
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Provider Business Mailing Address
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Address Line | 170 PLAYERS CIR SUITE 100
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6942
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Country | US
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Telephone | 682-553-7800
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Fax | 817-488-8927
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARLES WAYNE HEBERT
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Credential | D.C.
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Telephone | 682-553-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number |
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License Number State | TX
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