Provider Demographics
NPI:1205095585
Name:CHAMBERS, CHRIS R (DO)
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:R
Last Name:CHAMBERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 FULTON ST STE 203
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-2661
Mailing Address - Country:US
Mailing Address - Phone:940-382-2646
Mailing Address - Fax:940-384-1610
Practice Address - Street 1:1300 FULTON ST STE 203
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2661
Practice Address - Country:US
Practice Address - Phone:940-382-2646
Practice Address - Fax:940-384-1610
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101017604208600000X
TXP6795208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX306416YKP5Medicare PIN
TX306416YKQLMedicare PIN