Individual
CHAD MICHAEL MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2421 WORTH ST, HEMPHILL, TX 75948-7215
(409) 787-1416
(409) 787-1419
Mailing address
2421 WORTH ST, HEMPHILL, TX 75948-7215
(409) 787-1416
(409) 787-1419
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA04719
TX
363AM0700X
Medical Physician Assistant
Primary
PA04719
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1070770
PA NATIONAL CERTIFICATION
TX
05
—
191096002
—
TX
Enumeration date
04/07/2006
Last updated
03/07/2022
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