Provider Demographics
NPI:1700921376
Name:CHAPMAN, MARTHA DANIEL (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:DANIEL
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 BERQUIST DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78255-2035
Mailing Address - Country:US
Mailing Address - Phone:210-292-5478
Mailing Address - Fax:
Practice Address - Street 1:2200 BERGQUIST DR
Practice Address - Street 2:LACKLAND AIR FORCE BASE
Practice Address - City:LACKLAND A F B
Practice Address - State:TX
Practice Address - Zip Code:78236-9907
Practice Address - Country:US
Practice Address - Phone:210-292-5478
Practice Address - Fax:210-292-5419
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202203433183500000X
FLPS31545183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist