Provider Demographics
NPI:1609836527
Name:MENARD, CONSTANCE CHAMBERLAIN (MD)
Entity Type:Individual
Prefix:DR
First Name:CONSTANCE
Middle Name:CHAMBERLAIN
Last Name:MENARD
Suffix:
Gender:F
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:PO BOX 425467
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76204-5467
Mailing Address - Country:US
Mailing Address - Phone:940-898-3826
Mailing Address - Fax:940-898-3844
Practice Address - Street 1:304 ADMINISTRATION DRIVE
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201
Practice Address - Country:US
Practice Address - Phone:940-898-3826
Practice Address - Fax:940-898-3844
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2202208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG14323Medicare UPIN