MEDICARE: HANNAN CHAUGLE 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	2086S0129X	Vascular Surgery Physician	A97091	CA
2	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	MD25493	OR
3	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	MD60036943	WA
4	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	A97091	CA
5	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	R7414	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0241714	OTHER	WA	LABOR & INDUSTRIES

General Provider Information

NPI Number	:	1730100660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAN CHAUGLE M.D.

Provider Business Mailing Address
First Line	:	450 W MEDICAL CENTER BLVD STE 600
Second Line	:
City	:	WEBSTER
State	:	TX
Zip	:	77598-4233
Country	:	US
Telephone Number	:	281-316-2612
Fax Number	:	281-316-2811

Provider Business Practice Location Address
First Line	:	450 W MEDICAL CENTER BLVD STE 600
Second Line	:
City	:	WEBSTER
State	:	TX
Zip	:	77598-4233
Country	:	US
Telephone Number	:	281-316-2612
Fax Number	:	281-316-2811

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

Provider Enumeration Date	:	07/23/2006
Last Update Date	:	01/26/2022

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Directions to “ HANNAN CHAUGLE M.D.” Practice Location

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