Provider Demographics
NPI:1649277286
Name:CHADWICK, TUESDAY L (MD)
Entity type:Individual
Prefix:
First Name:TUESDAY
Middle Name:L
Last Name:CHADWICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2870 LEWIS LN
Mailing Address - Street 2:STE 218
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-9380
Mailing Address - Country:US
Mailing Address - Phone:903-785-6448
Mailing Address - Fax:903-785-6498
Practice Address - Street 1:2870 LEWIS LN
Practice Address - Street 2:STE 218
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-9380
Practice Address - Country:US
Practice Address - Phone:903-785-6448
Practice Address - Fax:903-785-6498
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-28
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1815207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0003GUOtherBCBS
OK100169860BMedicaid
TX140823902Medicaid
TX140823902Medicaid
TX0003GUOtherBCBS
TX0003GUOtherBCBS