Provider Demographics
NPI:1497297394
Name:HALBLEIB, CHELSEA LYNN (PA)
Entity Type:Individual
Prefix:MISS
First Name:CHELSEA
Middle Name:LYNN
Last Name:HALBLEIB
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:777 S FRY RD
Mailing Address - Street 2:STE 206
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2297
Mailing Address - Country:US
Mailing Address - Phone:410-739-1223
Mailing Address - Fax:
Practice Address - Street 1:1331 W GRAND PKWY N STE 350
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-2711
Practice Address - Country:US
Practice Address - Phone:410-739-1223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-08
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA10881363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical