Individual
DR. CHAD R NILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2026 S JACKSON ST, JACKSONVILLE, TX 75766-5822
(903) 541-4500
(903) 541-0791
Mailing address
PO BOX 847522, DALLAS, TX 75284-7522
(903) 531-5000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
L0882
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044936507
—
TX
01
—
8V5498
BCBS TC RADIOLOGY
TX
Enumeration date
02/17/2006
Last updated
12/05/2025
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