Provider Demographics
NPI:1396974150
Name:ADAMS, CHESLEY HILLIARY (DPT)
Entity type:Individual
Prefix:
First Name:CHESLEY
Middle Name:HILLIARY
Last Name:ADAMS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4129 WALNUT HILLS
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-2030
Mailing Address - Country:US
Mailing Address - Phone:940-232-6303
Mailing Address - Fax:
Practice Address - Street 1:5633 S. STAPLES STREET
Practice Address - Street 2:SUITE 400 & 500
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4646
Practice Address - Country:US
Practice Address - Phone:361-855-1352
Practice Address - Fax:361-855-1254
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1172560225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX204355601Medicaid
TX1172560OtherPHYSICAL THERAPY LICENSE NUMBER