Individual
CHANDLER N THIBODAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A
Contact information
Practice address
1307 8TH AVE STE 505, FORT WORTH, TX 76104-4143
(817) 927-2332
Mailing address
413 EAGLE DR, BEDFORD, TX 76021-3219
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
01790
TX
Other
Enumeration date
02/02/2007
Last updated
06/11/2014
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