Provider Demographics
NPI:1093832842
Name:CHCC INC
Entity Type:Organization
Organization Name:CHCC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:L
Authorized Official - Last Name:KREISLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-324-4221
Mailing Address - Street 1:1151 N. BUCKNER BLVD
Mailing Address - Street 2:PB1 SUITE 203
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218
Mailing Address - Country:US
Mailing Address - Phone:214-324-4221
Mailing Address - Fax:972-686-6391
Practice Address - Street 1:1151 N. BUCKNER BLVD
Practice Address - Street 2:PB1 SUITE 203
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218
Practice Address - Country:US
Practice Address - Phone:214-324-4221
Practice Address - Fax:972-686-6391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX112124602Medicaid
TX137275704Medicaid
TX133430202Medicaid