Individual
JOHN A CHAUCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
6606 LYNDON B JOHNSON FWY STE 200, DALLAS, TX 75240-6524
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-0426
(972) 715-5000
(972) 715-9976
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
709225
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
199514402
—
TX
01
—
2224617
DRIVER LICENSE
TX
01
—
709225
STATE LICENSE
TX
01
—
89694U
BCBS
TX
01
—
P00679407
RAILROAD
TX
Enumeration date
12/23/2008
Last updated
06/23/2020
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