=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982117032
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOSEF GIOVANNI CHAPMAN LICENSED BARBER
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/12/2017
-----------------------------------------------------
Last Update Date | 11/12/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5550 EASTEX FWY STE E
-----------------------------------------------------
City | BEAUMONT
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77708-5300
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 409-338-3233
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5550 EASTEX FWY STE E
-----------------------------------------------------
City | BEAUMONT
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77708-5300
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 409-338-3233
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1744P3200X
-----------------------------------------------------
Taxonomy Name | Prosthetics Case Management
-----------------------------------------------------
License Number | 637535
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------