Provider Demographics
NPI:1285642603
Name:CHAMALES, MICHAEL HOOD (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:HOOD
Last Name:CHAMALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15010 FM 1730
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-6635
Mailing Address - Country:US
Mailing Address - Phone:806-863-4206
Mailing Address - Fax:806-863-4207
Practice Address - Street 1:15010 SLIDE DR
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424
Practice Address - Country:US
Practice Address - Phone:806-872-4179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE-2504207Q00000X
TXE2504207N00000X, 207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1401648-03Medicaid
TX93-0724316OtherTAX ID
TXC92380Medicare UPIN
TX00D11TMedicare ID - Type Unspecified