Provider Demographics
NPI:1548280043
Name:NIX, CHET J (DC)
Entity type:Individual
Prefix:
First Name:CHET
Middle Name:J
Last Name:NIX
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 788
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:TX
Mailing Address - Zip Code:75103
Mailing Address - Country:US
Mailing Address - Phone:903-567-1910
Mailing Address - Fax:903-567-1497
Practice Address - Street 1:1108 SO BUFFALO
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:TX
Practice Address - Zip Code:75103
Practice Address - Country:US
Practice Address - Phone:903-567-1910
Practice Address - Fax:903-567-1497
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8110111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AK290Medicare PIN