Provider Demographics
NPI:1316496573
Name:CHAPMAN, MONICA ELYSE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:ELYSE
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:MONICA
Other - Middle Name:ELYSE
Other - Last Name:GAMBOA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:7703 FLOYD CURL DR # MC7977
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-450-9600
Mailing Address - Fax:210-450-6036
Practice Address - Street 1:8300 FLOYD CURL DR
Practice Address - Street 2:4TH FLOOR -4B
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229
Practice Address - Country:US
Practice Address - Phone:210-450-9600
Practice Address - Fax:210-450-6036
Is Sole Proprietor?:No
Enumeration Date:2016-09-29
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA10879363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX363995701Medicaid
TX363995702OtherCSHCN
TX363995701Medicaid