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General NPI Number Information
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NPI Number | 1285459388
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Entity Type | Individual
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Provider Name | CHELSEY DENAE CHEATHAM PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/22/2024
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Last Update Date | 11/29/2025
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Provider Practice Location Address
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Address Line | 1210 W BRAKER LN
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City | AUSTIN
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State | TX
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Zip | 78758-3801
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Country | US
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Telephone | 512-978-9300
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Fax | 512-901-9737
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Provider Business Mailing Address
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Address Line | 1109 E BROADWAY ST
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City | CUERO
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State | TX
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Zip | 77954-2108
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Country | US
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Telephone | 361-275-2800
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Fax | 361-275-8791
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA18478
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA65238
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License Number State | CA
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