Individual
CHASE RYAN KORNEGAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4100 INTERNATIONAL PLZ, SUITE 600, FORT WORTH, TX 76109-4820
(817) 334-0530
(817) 877-0350
Mailing address
2100 LAKESIDE BLVD, STE 250, RICHARDSON, TX 75082-4351
(972) 422-5941
(972) 881-4390
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
24482
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200243250A
—
OK
Enumeration date
02/05/2007
Last updated
01/26/2018
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