Individual
JEFFREY A CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6100 HARRIS PKWY, FORT WORTH, TX 76132-4124
(817) 570-8500
Mailing address
PO BOX 8549, FORT WORTH, TX 76124-0549
(817) 451-4208
(817) 563-3699
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
L2182
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039GU
BCBS
TX
05
—
144182601
—
TX
Enumeration date
05/26/2006
Last updated
06/10/2013
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