Provider Demographics
NPI:1518958701
Name:CHANDLER, JOHN RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:RICHARD
Last Name:CHANDLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 W 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1702
Mailing Address - Country:US
Mailing Address - Phone:806-355-9531
Mailing Address - Fax:806-355-0938
Practice Address - Street 1:6000 W 9TH AVE
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1702
Practice Address - Country:US
Practice Address - Phone:806-355-9531
Practice Address - Fax:806-355-0938
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-04
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7684207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX161956101Medicaid
TX161956101Medicaid
609972Medicare ID - Type Unspecified