Provider Demographics
NPI:1366547390
Name:CHAPPELL, VICKY L (MD)
Entity type:Individual
Prefix:DR
First Name:VICKY
Middle Name:L
Last Name:CHAPPELL
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 1:5012 S US HIGHWAY 75 STE 300
Mailing Address - Street 2:ATTN. BILLING
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-4589
Mailing Address - Country:US
Mailing Address - Phone:903-868-4595
Mailing Address - Fax:
Practice Address - Street 1:600 E TAYLOR ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-2881
Practice Address - Country:US
Practice Address - Phone:903-868-4595
Practice Address - Fax:903-868-4597
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3494208600000X, 2086S0102X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1808891-02Medicaid
TX8GF376OtherBCBS TX
TX8GF376OtherBCBS TX
I51971Medicare UPIN