Provider Demographics
NPI:1457365603
Name:MOFFITT, CHAD E (OD)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:E
Last Name:MOFFITT
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:555 E MEDICAL CENTER BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4367
Mailing Address - Country:US
Mailing Address - Phone:281-488-7213
Mailing Address - Fax:281-488-1387
Practice Address - Street 1:1913 STEELE RD
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-5526
Practice Address - Country:US
Practice Address - Phone:281-488-7213
Practice Address - Fax:281-824-8711
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX5433TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX036840903Medicaid
TX036840903Medicaid
TXU67069Medicare UPIN