Provider Demographics
NPI:1912329475
Name:CHALAS, AMBER AMY (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:AMY
Last Name:CHALAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 WINDCROSS CT
Mailing Address - Street 2:STE 101
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2678
Mailing Address - Country:US
Mailing Address - Phone:615-224-5438
Mailing Address - Fax:855-247-8787
Practice Address - Street 1:5749 SAN FELIPE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-3101
Practice Address - Country:US
Practice Address - Phone:208-251-3418
Practice Address - Fax:855-247-8787
Is Sole Proprietor?:No
Enumeration Date:2014-01-16
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA08884363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX360473YWZ9OtherMEDICARE ID