Provider Demographics
NPI:1720367725
Name:CHAPMAN, ANDREW THOMAS (ATP)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:THOMAS
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:944 MELBOURNE RD
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76053-4633
Mailing Address - Country:US
Mailing Address - Phone:817-589-1110
Mailing Address - Fax:817-595-1984
Practice Address - Street 1:944 MELBOURNE RD
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76053-4633
Practice Address - Country:US
Practice Address - Phone:817-589-1110
Practice Address - Fax:817-595-1984
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXATP912225CA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225CA2400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX142593601Medicaid
TX142593601Medicaid