Basic Information
| Provider Information | |||||||||
| NPI: | 1942237003 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHAMBLEE | ||||||||
| FirstName: | SOCORRO | ||||||||
| MiddleName: | ALCALEN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8080 STATE HIGHWAY 121 | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | MCKINNEY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750702900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143835955 | ||||||||
| FaxNumber: | 2143835966 | ||||||||
| Practice Location | |||||||||
| Address1: | 2001 INWOOD RD | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753902900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146458898 | ||||||||
| FaxNumber: | 2146458894 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2006 | ||||||||
| LastUpdateDate: | 02/26/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | L6316 | TX | N | Other Service Providers | Specialist | 207Y00000X | L6316 | TX | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
ID Information
| ID | Type | State | Issuer | Description | 200191640 | 05 | TX | MEDICAID |