Basic Information
| Provider Information | |||||||||
| NPI: | 1982665550 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STRANGE | ||||||||
| FirstName: | CHAD | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1905 SW H K DODGEN LOOP | ||||||||
| Address2: | |||||||||
| City: | TEMPLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 765021814 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2542982682 | ||||||||
| FaxNumber: | 2547787197 | ||||||||
| Practice Location | |||||||||
| Address1: | 1905 SW H K DODGEN LOOP | ||||||||
| Address2: | |||||||||
| City: | TEMPLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 765021814 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2542982682 | ||||||||
| FaxNumber: | 2547787197 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2006 | ||||||||
| LastUpdateDate: | 09/25/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | K7910 | TX | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207Q00000X | K7910 | TX | N | Allopathic & Osteopathic Physicians | Family Medicine | 2085R0202X | K7910 | TX | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | K7910 | 01 | TX | TX MEDICAL LICENSE | OTHER |