Provider Demographics
NPI:1982939054
Name:CHAPA, CARLOS (LAC, PHD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:
Last Name:CHAPA
Suffix:
Gender:M
Credentials:LAC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9901 VALLEY RANCH PKWY EAST
Mailing Address - Street 2:1000
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-4318
Mailing Address - Country:US
Mailing Address - Phone:972-444-0660
Mailing Address - Fax:
Practice Address - Street 1:9901 VALLEY RANCH PKWY EAST
Practice Address - Street 2:1000
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-4318
Practice Address - Country:US
Practice Address - Phone:972-444-0660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-07
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171100000X
TXAC01173171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist