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Individual

CHASE KNICKERBOCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7201
(305) 951-5085
Mailing address
9425 SW 181ST TER, SURGERY DEPT., PALMETTO BAY, FL 33157-5626
(305) 951-5085

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
S5410
TX
2086S0102X
Surgical Critical Care Physician
Primary
S5410
TX

Other

Enumeration date
04/10/2015
Last updated
06/06/2024
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