MEDICARE: CHANDRA ANNE MCDONALD 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
1	363A00000X	Physician Assistant	PA.0003574	CO
2	363A00000X	Physician Assistant	PA11049	TX

General Provider Information

NPI Number	:	1619228798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANDRA ANNE MCDONALD PA-C

Provider Business Mailing Address
First Line	:	5929 BALCONES DR STE 200
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-4280
Country	:	US
Telephone Number	:	512-550-1800
Fax Number	:

Provider Business Practice Location Address
First Line	:	23530 KINGSLAND BLVD STE 203
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-7466
Country	:	US
Telephone Number	:	713-766-5437
Fax Number	:

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

Provider Enumeration Date	:	09/28/2012
Last Update Date	:	10/19/2022

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