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General NPI Number Information
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NPI Number | 1710271325
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Entity Type | Organization
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Legal Business Name | TROY CHANDLER P.A., P.C.
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Dates
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Enumeration Date | 06/01/2011
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Last Update Date | 06/01/2011
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Provider Practice Location Address
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Address Line | 1713 S FM 51 #103
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City | DECATUR
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State | TX
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Zip | 76234-3642
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Country | US
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Telephone | 940-577-1557
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Fax |
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Provider Business Mailing Address
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Address Line | 1713 S FM 51 #103
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City | DECATUR
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State | TX
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Zip | 76234-3642
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Country | US
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Telephone | 940-577-1557
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | TROY CHANDLER
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Credential | PA
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Telephone | 940-577-1557
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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 | PA04190
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License Number State | TX
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