Individual
FLENNELL CHALK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
755 S BECKHAM AVE, TYLER, TX 75701-1903
(903) 534-4684
Mailing address
2162 RED MAPLE RD, BIG SANDY, TX 75755-4296
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
753888
TX
Other
Enumeration date
10/24/2019
Last updated
10/24/2019
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