Provider Demographics
NPI:1497715999
Name:JOHN D. CHATELAIN, O.D.,P.A.
Entity Type:Organization
Organization Name:JOHN D. CHATELAIN, O.D.,P.A.
Other - Org Name:COPPERFIELD VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHATELAIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-550-2020
Mailing Address - Street 1:8100 HIGHWAY 6 N
Mailing Address - Street 2:SUITE A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-1900
Mailing Address - Country:US
Mailing Address - Phone:281-550-2020
Mailing Address - Fax:281-550-2505
Practice Address - Street 1:8100 HIGHWAY 6 N
Practice Address - Street 2:SUITE A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-1900
Practice Address - Country:US
Practice Address - Phone:281-550-2020
Practice Address - Fax:281-550-2505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-27
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4620TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU49856Medicare UPIN