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NPI Code Detail

MEDICARE: CHAMBERS COMMUNITY HEALTH CENTERS, INC.

MEDICARE: CHAMBERS COMMUNITY HEALTH CENTERS, INC.
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
1363LF0000XFamily Nurse Practitioner

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11047214OTHERTXTEXAS BOARD OF NURSING LICENSURE

General Provider Information

NPI Number : 1285300145
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHAMBERS COMMUNITY HEALTH CENTERS, INC.
Provider Business Mailing Address
First Line : 1603 LAKE POINTE LN
Second Line :
City : BAYTOWN
State : TX
Zip : 77523-9407
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9825 EAGLE DR
Second Line :
City : MONT BELVIEU
State : TX
Zip : 77523-9847
Country : US
Telephone Number : 281-576-0670
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : KALEY SMITH
Credential : MHA
Telephone Number : 409-267-4126
Provider Enumeration Date : 08/20/2021
Last Update Date : 08/20/2021

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