Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 32373 | TX |
N | 103T00000X | Psychologist | 32373 | TX |
N | 103G00000X | Clinical Psychologist | 32373 | TX |
N | 103TC0700X | Clinical Psychologist | 32373 | TX |
N | 103TC1900X | Counseling Psychologist | 32373 | TX |
N | 103TF0000X | Family Psychologist | 32373 | TX |
N | 103TH0100X | Health Service | 32373 | TX |
NPI | 1003805078 |
---|---|
Provider Name | Dr. Gary H. Chase |
First Address | Frisco, TX 75034-3246 |
Second Address | Frisco, TX 75034-3246 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0024LV | BCBS (01) | TX |
063003 | VALUE OPTIONS (01) | |
217437 | MANAGED HEALTH NETWORK (01) | |
7539799 | AETNA (01) | |
80314 | UNICARE (01) |