MEDICARE: MR. ANDREW HUNTER CHARD

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	1041C0700X	Clinical Social Worker	107994	TX

General Provider Information

NPI Number	:	1992684021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANDREW HUNTER CHARD

Provider Business Mailing Address
First Line	:	4516 ROCKMILL TRL
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76179-5091
Country	:	US
Telephone Number	:	843-496-0492
Fax Number	:	843-496-0492

Provider Business Practice Location Address
First Line	:	4516 ROCKMILL TRL
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76179-5091
Country	:	US
Telephone Number	:	843-496-0492
Fax Number	:	843-496-0492

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

Provider Enumeration Date	:	09/02/2025
Last Update Date	:	09/02/2025

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