Provider Demographics
NPI:1316414600
Name:CHASEN COMMUNITY CARE CLINIC, PLLC
Entity Type:Organization
Organization Name:CHASEN COMMUNITY CARE CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOBBS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:346-335-2103
Mailing Address - Street 1:6550 MAPLERIDGE ST STE 216
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-4648
Mailing Address - Country:US
Mailing Address - Phone:346-335-2103
Mailing Address - Fax:346-335-1958
Practice Address - Street 1:6550 MAPLERIDGE ST STE 216
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-4648
Practice Address - Country:US
Practice Address - Phone:346-335-2103
Practice Address - Fax:346-335-1958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-25
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty