Doctor Name: | MR. HAROLD LOYD CHISM |
NPI Number: | 1346393139 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA |
License Number: | PA00425 |
Business Practice Address: | 207 W Avenue E Lampasas, TX - 765501820 |
Business Phone Number: | 5125563621 |
Business Fax Number: | 5125566594 |
Mailing Address: | 207 W Avenue E, LAMPASAS |
State: | TX |
Postal Code: | 765501820 |
Phone Number: | 5125563621 |
Fax Number: | 5125566594 |
NPI Enumeration Date: | 01/18/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA00425 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |