Provider Demographics
NPI:1376683672
Name:JONES, CHAUNCEY TALLAFERRO (MD)
Entity Type:Individual
Prefix:DR
First Name:CHAUNCEY
Middle Name:TALLAFERRO
Last Name:JONES
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 1:33910 HIGH POINT DRIVE
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77355
Mailing Address - Country:US
Mailing Address - Phone:281-356-8208
Mailing Address - Fax:
Practice Address - Street 1:7010 CHAMPIONS PLAZA DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069
Practice Address - Country:US
Practice Address - Phone:832-698-5320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0065872207L00000X
TXM9386207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDV0353OtherPRACTICIONER HOSPITAL ID#
TXM9386OtherTEXAS MEDICAL BOARD
MDD0065872OtherMARYLAND LICENSE NUMBER