Jacob C Hamblen, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

13812 Issued in TX

Practice address

4560 Lake Ridge Pkwy Ste 200
Grand Prairie, TX 75052-1706

Phone

(800) 404-6050

Fax

(866) 313-3397

NPI assigned

Jul 10, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1063908390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 700688",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782700688",
            "telephone_number": "210-477-7654",
            "fax_number": "210-468-0682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 LAKE RIDGE PKWY STE 200",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750521706",
            "telephone_number": "800-404-6050",
            "fax_number": "866-313-3397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMBLEN",
        "first_name": "JACOB",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-10",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "13812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF CHIROPRACTIC EXAMINERS",
            "identifier": "13812",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Hagan
• Charlotte M Hagens, MT
• Glen Bruce Hake Jr., D.C.
• Ada M Hall, LPC
• Angela Marcia Hamberlin
• Deanna Angela Hammond, O.D.
• Hands2Hand Behavioral Health Center
• Randi Alyse Hanfeld, PTA
• Lane Hankins, PTA
• Hannah Amaefula

• Chiropractor in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.