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Individual

DR. CHARLES MARK CHASSAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
855 MONTGOMERY ST, FORT WORTH, TX 76107-2553
(817) 735-2228
Mailing address
855 MONTGOMERY ST, FORT WORTH, TX 76107-2553

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
J4035
TX
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
J4035
TX

Other

Enumeration date
08/07/2006
Last updated
11/13/2020
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