Healthcare Provider Details

I. General information

NPI: 1053451815
Provider Name (Legal Business Name): ANDREA ELEANOR CHESSER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 12/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5009 COLLEGE AVE
SNYDER TX
79549
US

IV. Provider business mailing address

5009 COLLEGE AVE
SNYDER TX
79549
US

V. Phone/Fax

Practice location:
  • Phone: 325-573-1300
  • Fax: 325-573-2134
Mailing address:
  • Phone: 325-573-1300
  • Fax: 325-573-2134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA03322
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: