Provider Demographics
NPI:1043285836
Name:CHESSHIR, WALTER LEE III (MD)
Entity type:Individual
Prefix:
First Name:WALTER
Middle Name:LEE
Last Name:CHESSHIR
Suffix:III
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 JOHN W HOOVER PKWY
Mailing Address - Street 2:BLDG 1, STE A
Mailing Address - City:BURNET
Mailing Address - State:TX
Mailing Address - Zip Code:78611-4561
Mailing Address - Country:US
Mailing Address - Phone:512-715-3110
Mailing Address - Fax:512-715-0678
Practice Address - Street 1:200 JOHN W HOOVER PKWY
Practice Address - Street 2:BLDG 1, STE A
Practice Address - City:BURNET
Practice Address - State:TX
Practice Address - Zip Code:78611-4561
Practice Address - Country:US
Practice Address - Phone:512-715-3110
Practice Address - Fax:512-715-0678
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6826207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX160377103Medicaid
TX8G9385OtherBCBS
TX160377103Medicaid
TX8G9385OtherBCBS
TXP00314332Medicare PIN