Provider Demographics
NPI:1013112804
Name:CHAPMAN, ALISSA MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALISSA
Middle Name:MARIE
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3435 S ALAMEDA ST
Mailing Address - Street 2:SUITE #A
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-1751
Mailing Address - Country:US
Mailing Address - Phone:361-853-0381
Mailing Address - Fax:
Practice Address - Street 1:3435 S ALAMEDA ST
Practice Address - Street 2:SUITE #A
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1751
Practice Address - Country:US
Practice Address - Phone:361-853-0381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23559122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188065002Medicaid