Individual
GERAD CHANCELLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1205 SENECA PL, GLENN HEIGHTS, TX 75154-8821
(469) 337-3711
Mailing address
1205 SENECA PL, GLENN HEIGHTS, TX 75154-8821
(469) 337-3711
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
TX
251T00000X
PACE Provider Organization
—
TX
320700000X
Physical Disabilities Residential Treatment Facility
—
TX
Other
Enumeration date
09/16/2025
Last updated
09/16/2025
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