Provider Demographics
NPI:1790928232
Name:CHANDLER, WEST (MD)
Entity Type:Individual
Prefix:
First Name:WEST
Middle Name:
Last Name:CHANDLER
Suffix:
Gender:M
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 1325
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:TX
Mailing Address - Zip Code:75671-1325
Mailing Address - Country:US
Mailing Address - Phone:903-934-5280
Mailing Address - Fax:903-934-5481
Practice Address - Street 1:620 S GROVE ST
Practice Address - Street 2:SUITE 105
Practice Address - City:MARSHALL
Practice Address - State:TX
Practice Address - Zip Code:75670-5269
Practice Address - Country:US
Practice Address - Phone:903-934-5280
Practice Address - Fax:903-934-5481
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA204837207Q00000X
TXP4939207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine