Provider Demographics
NPI:1528301595
Name:CHALA, COLIN (DC)
Entity type:Individual
Prefix:
First Name:COLIN
Middle Name:
Last Name:CHALA
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 1:2612 S JOHN REDDITT DR
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-5625
Mailing Address - Country:US
Mailing Address - Phone:936-637-2225
Mailing Address - Fax:936-637-2227
Practice Address - Street 1:2612 S JOHN REDDITT DR
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904
Practice Address - Country:US
Practice Address - Phone:936-637-2225
Practice Address - Fax:936-637-2227
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-28
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12142111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor