Provider Demographics
NPI:1831190966
Name:CHATELAIN, JOHN DAVID (OD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAVID
Last Name:CHATELAIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8100 HIGHWAY 6 N
Mailing Address - Street 2:SUITE A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-1900
Mailing Address - Country:US
Mailing Address - Phone:281-550-2020
Mailing Address - Fax:281-550-2505
Practice Address - Street 1:8100 HIGHWAY 6 N
Practice Address - Street 2:SUITE A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-1900
Practice Address - Country:US
Practice Address - Phone:281-550-2020
Practice Address - Fax:281-550-2505
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2007-09-28
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
TX4620TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU49856Medicare UPIN