Individual
DR. JOHN R CHANCE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6704 RANDOLPH BLVD, LIVE OAK, TX 78233-4222
(210) 477-5151
(210) 477-5152
Mailing address
12709 TOEPPERWEIN RD, STE 101, LIVE OAK, TX 78233-3259
(210) 477-5151
(210) 477-5152
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
K5269
TX
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
K5269
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00983033
RAILROAD MEDICARE
TX
Enumeration date
01/03/2007
Last updated
01/25/2022
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