Healthcare Provider Details

I. General information

NPI: 1487643524
Provider Name (Legal Business Name): PETROS KOSMAS CHAPANOS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 FM 300
LEVELLAND TX
79336-6235
US

IV. Provider business mailing address

1000 FM 300
LEVELLAND TX
79336-6235
US

V. Phone/Fax

Practice location:
  • Phone: 806-894-7842
  • Fax: 806-894-3378
Mailing address:
  • Phone: 806-894-7842
  • Fax: 806-894-3378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberJ9640
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: