Provider Demographics
NPI:1790206969
Name:CHAPADOS, JAYME LAUREN (PA-C)
Entity Type:Individual
Prefix:
First Name:JAYME
Middle Name:LAUREN
Last Name:CHAPADOS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 8TH AVE STE 326
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-2602
Mailing Address - Country:US
Mailing Address - Phone:817-885-8222
Mailing Address - Fax:817-885-8663
Practice Address - Street 1:800 8TH AVE STE 326
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104
Practice Address - Country:US
Practice Address - Phone:817-885-8222
Practice Address - Fax:817-885-8663
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA11322363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA11322OtherTEXAS MEDICAL BOARD