Provider Demographics
NPI:1912220971
Name:CHADON SERVICES
Entity Type:Organization
Organization Name:CHADON SERVICES
Other - Org Name:CHADON SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:N
Authorized Official - Last Name:NKEM
Authorized Official - Suffix:
Authorized Official - Credentials:MANAGER
Authorized Official - Phone:713-548-3613
Mailing Address - Street 1:9475 W SAM HOUSTON PKWY S APT 240
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-5801
Mailing Address - Country:US
Mailing Address - Phone:713-548-3613
Mailing Address - Fax:
Practice Address - Street 1:9475 W SAM HOUSTON PKWY S APT 240
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-5801
Practice Address - Country:US
Practice Address - Phone:713-548-3613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-05
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX305S00000X305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service