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NPI Code Detail

MEDICARE: MRS. CHANDRA DEEL OUD PA-C

MEDICARE: MRS. CHANDRA DEEL OUD PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA04304TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PA04304OTHERTXLICENSE

General Provider Information

NPI Number : 1245204288
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHANDRA DEEL OUD PA-C
Provider Business Mailing Address
First Line : 1317 N HILLCREST DR
Second Line :
City : SULPHUR SPRINGS
State : TX
Zip : 75482-2091
Country : US
Telephone Number : 903-438-1110
Fax Number : 903-438-1107
Provider Business Practice Location Address
First Line : 1317 N HILLCREST DR
Second Line :
City : SULPHUR SPRINGS
State : TX
Zip : 75482-2091
Country : US
Telephone Number : 903-438-1110
Fax Number : 903-438-1107
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2006
Last Update Date : 02/22/2024

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Directions to “ MRS. CHANDRA DEEL OUD PA-C” Practice Location

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