Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | F3836 | TX |
NPI | 1003960519 |
---|---|
Provider Name | Dr. Richard Anthony Chengson |
First Address | Abilene, TX 79602-5058 |
Second Address | Abilene, TX 79602-5058 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 26/07/2017 |