Provider Demographics
NPI:1104848589
Name:CHANDLER, BECKY L (MD)
Entity Type:Individual
Prefix:DR
First Name:BECKY
Middle Name:L
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1149 MODESTA DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-8538
Mailing Address - Country:US
Mailing Address - Phone:972-897-7399
Mailing Address - Fax:972-947-5570
Practice Address - Street 1:7651 ELDORADO PKWY STE 100
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-1735
Practice Address - Country:US
Practice Address - Phone:469-358-0768
Practice Address - Fax:972-947-5570
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0440207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX040198601Medicaid
TX08124058OtherRR MEDICARE
TX82231JMedicare ID - Type Unspecified
TXG72925Medicare UPIN