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General NPI Number Information
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NPI Number | 1003080078
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Entity Type | Individual
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Provider Name | REBECCA JEAN CHANCEY M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/21/2008
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Last Update Date | 08/06/2014
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Provider Practice Location Address
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Address Line | 6621A FANNIN ST.
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City | HOUSTON
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State | TX
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Zip | 77030
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Country | US
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Telephone | 713-770-5454
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Fax |
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Provider Business Mailing Address
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Address Line | 115 HIGHPOINT PASS
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City | FAYETTEVILLE
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State | GA
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Zip | 30215-8143
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 2011-00312
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | 2011-00312
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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