Provider Demographics
NPI:1548891336
Name:CHMELAR, COURTNEY JANE
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:JANE
Last Name:CHMELAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 WOODSON DR
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:TX
Mailing Address - Zip Code:77836-1000
Mailing Address - Country:US
Mailing Address - Phone:979-864-7701
Mailing Address - Fax:
Practice Address - Street 1:1004 WOODSON DR
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:TX
Practice Address - Zip Code:77836-1000
Practice Address - Country:US
Practice Address - Phone:979-864-7701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program