MEDICARE: DR. CHAD MARTIN AMOSSON MD

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	2085R0001X	Radiation Oncology Physician	L4219	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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790786879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHAD MARTIN AMOSSON MD

Provider Business Mailing Address
First Line	:	6957 W PLANO PKWY STE 1300
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-1621
Country	:	US
Telephone Number	:	972-820-1400
Fax Number	:	972-820-1020

Provider Business Practice Location Address
First Line	:	6957 W PLANO PKWY STE 1300
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-1621
Country	:	US
Telephone Number	:	972-820-1400
Fax Number	:	972-820-1020

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	04/02/2021

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