Provider Demographics
NPI:1295113538
Name:GARVEY, CHANDRA (RN,CPNP)
Entity type:Individual
Prefix:
First Name:CHANDRA
Middle Name:
Last Name:GARVEY
Suffix:
Gender:F
Credentials:RN,CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 SHIRE BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-2236
Mailing Address - Country:US
Mailing Address - Phone:469-333-1543
Mailing Address - Fax:877-878-9118
Practice Address - Street 1:3600 SHIRE BLVD STE 110
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-2236
Practice Address - Country:US
Practice Address - Phone:469-333-1543
Practice Address - Fax:877-878-9118
Is Sole Proprietor?:No
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP1080612080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine