Provider Demographics
NPI:1851476006
Name:CHCC INC.
Entity Type:Organization
Organization Name:CHCC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:L
Authorized Official - Last Name:KREISLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-324-4221
Mailing Address - Street 1:1151 N BUCKNER BLVD
Mailing Address - Street 2:PB1- SUITE 203
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-3426
Mailing Address - Country:US
Mailing Address - Phone:214-324-4221
Mailing Address - Fax:214-324-3705
Practice Address - Street 1:1151 N BUCKNER BLVD
Practice Address - Street 2:PB1- SUITE 203
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3426
Practice Address - Country:US
Practice Address - Phone:214-324-4221
Practice Address - Fax:214-324-3705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD33042080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX079563501Medicaid