Individual
MR. JOHN BRADLEY CHENAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NBC-HIS; A.C.A.
Contact information
Practice address
2112 STONEWALL ST, GREENVILLE, TX 75401-3344
(903) 455-5424
(903) 455-8922
Mailing address
2112 STONEWALL ST, GREENVILLE, TX 75401-3344
(903) 455-5424
(903) 455-8922
Taxonomy
Speciality
Code
Description
License number
State
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
Primary
50067
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022438801
—
TX
05
—
1871668970
—
TX
01
—
528263
BLUE CROSS BLUE SHIELD
TX
Enumeration date
03/14/2006
Last updated
05/16/2012
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