Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 9313 | TX |
NPI | 1003828401 |
---|---|
Provider Name | Dr. Charles Collin Hilliard |
First Address | Austin, TX 78750-1068 |
Second Address | Austin, TX 78750-1068 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8G2141 | BC/BS (01) | TX |
U91988 | (02) | TX |