Individual
MR. JEFFERY TYRONE CHISM II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2404 WINDSPRINT WAY APT 1215, ARLINGTON, TX 76014-1836
(817) 394-8798
Mailing address
2404 WINDSPRINT WAY APT 1215, ARLINGTON, TX 76014-1836
(817) 394-8798
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
343800000X
Secured Medical Transport (VAN)
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
372600000X
Adult Companion
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
Primary
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
02/20/2023
Last updated
02/20/2023
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