Provider Demographics
NPI:1285254391
Name:CHELSEA MEDICAL CENTER, LLC
Entity type:Organization
Organization Name:CHELSEA MEDICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, APRN, FNP-C
Authorized Official - Phone:214-694-6420
Mailing Address - Street 1:2108 DALLAS PKWY STE 214
Mailing Address - Street 2:BOX 585
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4362
Mailing Address - Country:US
Mailing Address - Phone:214-694-3420
Mailing Address - Fax:
Practice Address - Street 1:6600 MCKINNEY RANCH PKWY APT 12204
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-8453
Practice Address - Country:US
Practice Address - Phone:214-694-6420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-17
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty