Provider Demographics
NPI:1912958315
Name:CHICO, MARIA S (APNP)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:S
Last Name:CHICO
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 MEDICAL DISTRICT DR - MAIL: D10301.A
Mailing Address - Street 2:CHILDRENS MEDICAL CENTER DALLAS
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-7701
Mailing Address - Country:US
Mailing Address - Phone:214-456-4119
Mailing Address - Fax:
Practice Address - Street 1:1935 MEDICAL DISTRICT DR - MAIL: D10301.A
Practice Address - Street 2:CHILDREN'S MEDICAL CENTER
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7701
Practice Address - Country:US
Practice Address - Phone:214-456-4119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2013-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX844805363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
000011354QOtherHUMANA
WI41183700Medicaid
000011354QOtherHUMANA
P39538Medicare UPIN