Provider Demographics
NPI:1215905914
Name:CHUMLEY, BILLY B JR (OPTICIAN)
Entity type:Individual
Prefix:MR
First Name:BILLY
Middle Name:B
Last Name:CHUMLEY
Suffix:JR
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 296
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77492-0296
Mailing Address - Country:US
Mailing Address - Phone:281-391-3313
Mailing Address - Fax:281-391-3316
Practice Address - Street 1:1219 WINDING CANYON CT
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-8015
Practice Address - Country:US
Practice Address - Phone:281-391-3313
Practice Address - Fax:281-391-3316
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-09
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NOT REQUIRED156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0811040001Medicare NSC