MEDICARE: THOMAS CHICK M.D.

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
1	207RP1001X	Pulmonary Disease Physician	D3839	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8F3360	OTHER	TX	ADDITIONAL MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295738466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS CHICK M.D.

Provider Business Mailing Address
First Line	:	PO BOX 4550
Second Line	:
City	:	PALESTINE
State	:	TX
Zip	:	75802-4550
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3201 S LOOP 256
Second Line	:
City	:	PALESTINE
State	:	TX
Zip	:	75801-6901
Country	:	US
Telephone Number	:	903-723-8800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	03/30/2010

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Directions to “ THOMAS CHICK M.D.” Practice Location

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