Provider Demographics
NPI:1740264142
Name:THAM, CHUN Y (DC)
Entity type:Individual
Prefix:DR
First Name:CHUN
Middle Name:Y
Last Name:THAM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14855 BLANCO RD STE 310
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-7731
Mailing Address - Country:US
Mailing Address - Phone:210-281-4188
Mailing Address - Fax:210-281-4195
Practice Address - Street 1:14855 BLANCO RD STE 310
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-7731
Practice Address - Country:US
Practice Address - Phone:210-281-4188
Practice Address - Fax:210-281-4195
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 60119619111N00000X
OR273269111N00000X
IDCHIA 1275111N00000X
TX11917111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
R112008Medicare ID - Type Unspecified
U88587Medicare UPIN