Provider Demographics
NPI:1962390070
Name:CHANEY, LACHANDRA NICOLE
Entity type:Individual
Prefix:
First Name:LACHANDRA
Middle Name:NICOLE
Last Name:CHANEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 E DALLAS ST STE 107
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-2052
Mailing Address - Country:US
Mailing Address - Phone:469-770-3344
Mailing Address - Fax:214-278-0660
Practice Address - Street 1:1013 E DALLAS ST STE 107
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-2052
Practice Address - Country:US
Practice Address - Phone:469-770-3344
Practice Address - Fax:214-278-0660
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN24100729246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy