Provider Demographics
NPI:1386647162
Name:CHACON, FRANCISCO (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:
Last Name:CHACON
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 1:3529 HERITAGE TRACE PKWY STE 137
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-4971
Mailing Address - Country:US
Mailing Address - Phone:817-741-7960
Mailing Address - Fax:817-741-7581
Practice Address - Street 1:3529 HERITAGE TRACE PKWY STE 137
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-4971
Practice Address - Country:US
Practice Address - Phone:817-741-7960
Practice Address - Fax:817-741-7581
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8611207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144816902Medicaid
TX144816903Medicaid
H40622Medicare UPIN
TX144816903Medicaid
TX144816902Medicaid