Provider Demographics
NPI:1982241196
Name:PRITCHARD, CHANCE ALLEN (HIS)
Entity Type:Individual
Prefix:
First Name:CHANCE
Middle Name:ALLEN
Last Name:PRITCHARD
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 W THOMPSON ST APT 246
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-2468
Mailing Address - Country:US
Mailing Address - Phone:817-682-7222
Mailing Address - Fax:
Practice Address - Street 1:101 NW ELLISON ST # 109
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-4745
Practice Address - Country:US
Practice Address - Phone:817-882-6998
Practice Address - Fax:817-882-6996
Is Sole Proprietor?:No
Enumeration Date:2019-12-06
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80247237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist