Provider Demographics
NPI:1427051465
Name:MILES, CHESS LYNNETTE (DC)
Entity type:Individual
Prefix:DR
First Name:CHESS
Middle Name:LYNNETTE
Last Name:MILES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6733 FAIRMONT PKWY
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-4403
Mailing Address - Country:US
Mailing Address - Phone:713-946-7841
Mailing Address - Fax:281-991-7617
Practice Address - Street 1:6733 FAIRMONT PKWY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-4403
Practice Address - Country:US
Practice Address - Phone:713-946-7841
Practice Address - Fax:281-991-7617
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2008-07-15
Deactivation Date:2006-03-30
Deactivation Code:
Reactivation Date:2006-04-06
Provider Licenses
StateLicense IDTaxonomies
TX2586111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX350032561OtherPALMETTO GBA/ RAILROAD MC
TX600985Medicare ID - Type Unspecified
TX350032561OtherPALMETTO GBA/ RAILROAD MC