Doctor Name: | DR. ALFREDMY G CHESSOR |
NPI Number: | 1255312013 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 22199 |
Business Practice Address: | 1711 Doolittle Ave Fort Worth, TX - 761271133 |
Business Phone Number: | 8177825900 |
Business Fax Number: | 8177825952 |
Mailing Address: | 8309 Clearbrook Dr, FORT WORTH |
State: | TX |
Postal Code: | 761232311 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/09/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 22199 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |