Provider Demographics
NPI:1780743898
Name:DINGLER, CHANCE WAYNE (MD)
Entity type:Individual
Prefix:
First Name:CHANCE
Middle Name:WAYNE
Last Name:DINGLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30
Mailing Address - Street 2:
Mailing Address - City:NOCONA
Mailing Address - State:TX
Mailing Address - Zip Code:76255-0030
Mailing Address - Country:US
Mailing Address - Phone:940-825-3333
Mailing Address - Fax:940-825-3052
Practice Address - Street 1:90 PARK RD
Practice Address - Street 2:
Practice Address - City:NOCONA
Practice Address - State:TX
Practice Address - Zip Code:76255-3600
Practice Address - Country:US
Practice Address - Phone:940-825-3333
Practice Address - Fax:940-825-3052
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0286207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00D971OtherBCBS
TX89120XOtherBCBS
TX453876OtherMEDICARE PART A GROUP
TX00D971OtherMEDICARE PART B GROUP
TX89120XOtherBCBS
TX00D971OtherBCBS