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Individual

DR. PHILLIP CHAPA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
609 MEDICAL CENTER DR, DECATUR, TX 76234-3836
(940) 626-1249
Mailing address
130 COCO PLUM DR APT 401, MARATHON, FL 33050-4028
(940) 704-5309

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
K9750
TX
207P00000X
Emergency Medicine Physician
ME142967
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
090010203
TX
01
8G9184
BLUE CROSS BLUE SHIELD
TX
01
930123198
MEDICARE RR PALMETTO
TX
Enumeration date
05/02/2006
Last updated
03/28/2020
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