NPIMap

Organization Active NPI

Hebert Southlake Chiropractic

  • Orthopedic Chiropractor
  • Southlake, TX
National Provider Identifier
1730308198
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
4244 Issued in TX
Legal business name
HEBERT SOUTHLAKE CHIROPRACTIC
Practice address
170 Players Circle
#100
Southlake, TX 76092-6943
Phone
(817) 488-8837
Fax
(817) 488-8837
NPI assigned
Apr 24, 2007
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Dr. Charles Wayne Hebert, DCNPI 1942246129
Title
Owner
Phone
(817) 488-8837

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Chiropractor 111NX0800X 4244 TX Primary

Addresses

Primary practice location

170 Players Circle
#100
Southlake, TX 76092-6943

Mailing address

170 Players Circle
#100
Southlake, TX 76092
Phone (817) 488-8837

Other identifiers 3

IdentifierTypeStateIssuer
4632699OtherTXAETNA
0040PDOtherTXBLUECROSS BLUESHIELD
111N00000XOtherTXTAXONOMIES

National Provider Directory

National Provider Directory

Locations

170 Players Cir
Ste 100
Southlake, TX 76092
Phone (817) 488-8837

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1730308198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 PLAYERS CIRCLE",
            "address_2": "#100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "76092",
            "telephone_number": "817-488-8837",
            "fax_number": "817-488-8927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 PLAYERS CIRCLE",
            "address_2": "#100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926943",
            "telephone_number": "817-488-8837",
            "fax_number": "817-488-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEBERT SOUTHLAKE CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "HEBERT",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-488-8837",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "TX",
            "license": "4244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4632699",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "0040PD",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMIES",
            "identifier": "111N00000X",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.