MEDICARE: LACHANDRA NICOLE CHANEY

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	246RP1900X	Phlebotomy Technician	N24100729	TX

General Provider Information

NPI Number	:	1962390070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LACHANDRA NICOLE CHANEY

Provider Business Mailing Address
First Line	:	1013 E DALLAS ST STE 107
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-2052
Country	:	US
Telephone Number	:	469-770-3344
Fax Number	:	214-278-0660

Provider Business Practice Location Address
First Line	:	1013 E DALLAS ST STE 107
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-2052
Country	:	US
Telephone Number	:	469-770-3344
Fax Number	:	214-278-0660

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

Provider Enumeration Date	:	06/26/2025
Last Update Date	:	06/26/2025

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Directions to “ LACHANDRA NICOLE CHANEY ” Practice Location

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