Provider Demographics
NPI:1811073281
Name:DEWAYNE L CHAPMAN
Entity type:Organization
Organization Name:DEWAYNE L CHAPMAN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER-PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:DEWAYNE
Authorized Official - Middle Name:LLOYD
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:903-887-3711
Mailing Address - Street 1:PO BOX 561
Mailing Address - Street 2:
Mailing Address - City:MABANK
Mailing Address - State:TX
Mailing Address - Zip Code:75147-0561
Mailing Address - Country:US
Mailing Address - Phone:903-887-3711
Mailing Address - Fax:903-887-6674
Practice Address - Street 1:207 N 3RD ST
Practice Address - Street 2:
Practice Address - City:MABANK
Practice Address - State:TX
Practice Address - Zip Code:75147-8610
Practice Address - Country:US
Practice Address - Phone:903-887-3711
Practice Address - Fax:903-887-6674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4565959OtherNABP
TX4565959OtherNABP