Beaver, Chadwick Dale
Beaver, Chadwick Dale is an individual health care provider with primary practice located at 3601 21St St , Lubbock TX 79410-1229. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as his primary health care specialty. Beaver, Chadwick Dale can be contacted via phone (806) 791-0399.Contact Information
Primary practice address
3601 21St St
Lubbock TX 79410-1229
Phone: (806) 791-0399
Fax: (806) 791-0373
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Acute Care | 363LA2100X | AP118578 | Texas |
Profile Details
| NPI number | 1194054239 |
|---|---|
| LBN Legal business name | Beaver, Chadwick Dale |
| Credentials | ACNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 21st, 2009 |
| Last updated | Jan 20th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194054239 | NPPES |
| Texas | Other | 8295NS | BCBS |
| Texas | MEDICAID | 308679503 | BCBS |
| Texas | Other | 335111YKT8 | BCBS |
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