MEDICARE: CHEST DIAGNOSTIC THERAPEUTIC SERVICES, 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
1	332BX2000X	Oxygen Equipment & Supplies (DME)	0063617	TX
2	332B00000X	Durable Medical Equipment & Medical Supplies	0011667	TX

General Provider Information

NPI Number	:	1316944994
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHEST DIAGNOSTIC THERAPEUTIC SERVICES, INC

Provider Business Mailing Address
First Line	:	PO BOX 289
Second Line	:
City	:	MEXIA
State	:	TX
Zip	:	76667-0289
Country	:	US
Telephone Number	:	254-562-3803
Fax Number	:	254-562-2372

Provider Business Practice Location Address
First Line	:	105 N SHANNON ST
Second Line	:
City	:	KAUFMAN
State	:	TX
Zip	:	75142-1836
Country	:	US
Telephone Number	:	972-932-2642
Fax Number	:	972-932-4993

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	MR. WILLIAM H WRAGGE
Credential	:	RRT
Telephone Number	:	254-562-3803

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	09/11/2025

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