Individual
THERESA CHADWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
409 COTTAGE RD, CARTHAGE, TX 75633-1466
(903) 693-3841
(903) 694-4633
Mailing address
409 COTTAGE RD, CARTHAGE, TX 75633-1466
(903) 693-3841
(903) 694-4661
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA01697
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00374K
BLUE CROSS OF TEXAS
TX
05
—
0063445303
—
TX
05
—
063445302
—
TX
Enumeration date
11/06/2006
Last updated
08/10/2011
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