1285635029 NPI number — CRAIG A CHAMBERS M.D.

Table of content: CRAIG A CHAMBERS M.D. (NPI 1285635029)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285635029 NPI number — CRAIG A CHAMBERS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAMBERS
Provider First Name:
CRAIG
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285635029
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/17/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
03/20/2006
NPI Reactivation Date:
03/27/2006

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
977 RAINTREE CIR
Provider Second Line Business Mailing Address:
SUITE 230
Provider Business Mailing Address City Name:
ALLEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75013-5022
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-383-6611
Provider Business Mailing Address Fax Number:
214-383-6614

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
977 RAINTREE CIR
Provider Second Line Business Practice Location Address:
SUITE 230
Provider Business Practice Location Address City Name:
ALLEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75013-5022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-383-6611
Provider Business Practice Location Address Fax Number:
214-383-6614
Provider Enumeration Date:
08/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208100000X , with the licence number:  K8057 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2081S0010X , with the licence number: K8057 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 043240301 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8CR166 . This is a "BC/BS TX - EFFECT. 02/01/2011" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: TXB117536 . This is a "MEDICARE PART B - EFFECT. 02/01/2011" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 87040Y . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00913324 . This is a "MEDICARE RAILROAD - EFFECT 02/01/2011" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com