Provider Demographics
NPI:1285696914
Name:CHAPPELL, TIMOTHY RAE (MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:RAE
Last Name:CHAPPELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6100 WINDCOM CT
Mailing Address - Street 2:#102
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-7886
Mailing Address - Country:US
Mailing Address - Phone:972-964-0170
Mailing Address - Fax:972-596-8928
Practice Address - Street 1:1101 RAINTREE CIR STE 100
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-4999
Practice Address - Country:US
Practice Address - Phone:972-964-0170
Practice Address - Fax:972-596-8928
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2021-09-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXE7029207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122878503Medicaid
TX87W680Medicare PIN
TXB21781Medicare UPIN