Provider Demographics
NPI:1326087578
Name:CHAPMAN, DEWAYNE LLOYD (RPH)
Entity Type:Individual
Prefix:MR
First Name:DEWAYNE
Middle Name:LLOYD
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 561
Mailing Address - Street 2:
Mailing Address - City:MABANK
Mailing Address - State:TX
Mailing Address - Zip Code:75147-0561
Mailing Address - Country:US
Mailing Address - Phone:903-887-3711
Mailing Address - Fax:903-887-6674
Practice Address - Street 1:207 N 3RD ST
Practice Address - Street 2:
Practice Address - City:MABANK
Practice Address - State:TX
Practice Address - Zip Code:75147-8610
Practice Address - Country:US
Practice Address - Phone:903-887-3711
Practice Address - Fax:903-887-6674
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29128183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1230710001Medicare NSC
TX580103Medicare PIN