Provider Demographics
NPI:1902006125
Name:CHAPMAN, MARTHA JEAN (MD)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:JEAN
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 MCCULLAR ST
Mailing Address - Street 2:
Mailing Address - City:HALTOM CITY
Mailing Address - State:TX
Mailing Address - Zip Code:76117-4837
Mailing Address - Country:US
Mailing Address - Phone:817-834-6068
Mailing Address - Fax:
Practice Address - Street 1:6201 MCCULLAR ST
Practice Address - Street 2:
Practice Address - City:HALTOM CITY
Practice Address - State:TX
Practice Address - Zip Code:76117-4837
Practice Address - Country:US
Practice Address - Phone:817-834-6068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXC-4271207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC14390Medicare UPIN