Healthcare Provider Details

I. General information

NPI: 1851334205
Provider Name (Legal Business Name): CHAD D TRAMMELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 12/03/2021
Certification Date: 12/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1128 CLARKSVILLE STE 100
PARIS TX
75460-6089
US

IV. Provider business mailing address

1128 CLARKSVILLE STE 100
PARIS TX
75460-6089
US

V. Phone/Fax

Practice location:
  • Phone: 903-785-4362
  • Fax: 903-782-9365
Mailing address:
  • Phone: 903-785-4362
  • Fax: 903-782-9365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberK3027
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: