MEDICARE: JAMES E CHALK 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	44223	TN
2	2086S0129X	Vascular Surgery Physician	180091	NC
3	2086S0129X	Vascular Surgery Physician	43434	AZ
4	2086S0129X	Vascular Surgery Physician	S1997	TX

General Provider Information

NPI Number	:	1770762098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES E CHALK M.D.

Provider Business Mailing Address
First Line	:	PO BOX 4199
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78502-4199
Country	:	US
Telephone Number	:	956-322-7662
Fax Number	:	830-632-6568

Provider Business Practice Location Address
First Line	:	2511 CORNERSTONE BLVD STE 2511
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-8463
Country	:	US
Telephone Number	:	956-322-7662
Fax Number	:	830-632-6568

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

Provider Enumeration Date	:	11/02/2007
Last Update Date	:	10/11/2022

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