Provider Demographics
NPI:1871700013
Name:KAREN ELIZABETH CHAGNON DBA SENIOR CARE ASSOCIATES OF TEXAS
Entity type:Organization
Organization Name:KAREN ELIZABETH CHAGNON DBA SENIOR CARE ASSOCIATES OF TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:CHAGNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-469-1003
Mailing Address - Street 1:314 N EAST ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-7503
Mailing Address - Country:US
Mailing Address - Phone:817-469-1003
Mailing Address - Fax:817-265-8887
Practice Address - Street 1:314 N EAST ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-7503
Practice Address - Country:US
Practice Address - Phone:817-469-1003
Practice Address - Fax:817-265-8887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX079845601Medicaid
TX0008BYMedicare PIN
CE1515Medicare PIN