Provider Demographics
NPI:1922271659
Name:BILLY B CHUMLEY JR.
Entity Type:Organization
Organization Name:BILLY B CHUMLEY JR.
Other - Org Name:MOBILE OPHTHALMIC UNIT
Other - Org Type:Other Name
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-391-3313
Mailing Address - Street 1:5919-B GEORGE BUSH DRIVE
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-1937
Mailing Address - Country:US
Mailing Address - Phone:281-391-3313
Mailing Address - Fax:281-391-3316
Practice Address - Street 1:5919-B GEORGE BUSH DR.
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-1937
Practice Address - Country:US
Practice Address - Phone:281-391-3313
Practice Address - Fax:281-391-3316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NOT REQUIRED332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0865032-01Medicaid
TX0811040001Medicare NSC