Provider Demographics
NPI:1750893152
Name:ADAMS, CHAD NICHOLAS (PA)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:NICHOLAS
Last Name:ADAMS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:4222 WENDOVER AVE STE 600
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-5983
Mailing Address - Country:US
Mailing Address - Phone:432-552-5656
Mailing Address - Fax:432-552-0992
Practice Address - Street 1:3051 E UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-7902
Practice Address - Country:US
Practice Address - Phone:432-352-4376
Practice Address - Fax:432-552-0992
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-26
Last Update Date:2020-10-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical