Provider Demographics
NPI:1710975701
Name:CHAPMAN, JACK A (MD)
Entity Type:Individual
Prefix:MR
First Name:JACK
Middle Name:A
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:19141 STONE OAK PKWY STE 104
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3367
Mailing Address - Country:US
Mailing Address - Phone:210-268-0129
Mailing Address - Fax:210-568-4064
Practice Address - Street 1:717 GENERATIONS DR STE B
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-0009
Practice Address - Country:US
Practice Address - Phone:844-789-7246
Practice Address - Fax:210-568-4064
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH4227207L00000X, 207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX114814002Medicaid