CHAD PACANOWSKI (NPI# 1811314628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811314628 |
| Entity Type | Individual |
| Full Name | CHAD PACANOWSKI |
| Credential | PA-C |
| Practice Address |
805 Hill Blvd Suite #102 Granbury TX 76048-1481 |
| Practice Telephone | 8175797557 |
| Practice Fax Number | 8175796166 |
| Mailing Telephone | 8175797557 |
| Mailing Fax Number | 8175796166 |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2014-03-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA08968 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
805 HILL BLVD SUITE #102 |
| City | GRANBURY |
| State | TX |
| Zip Code | 76048-1481 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366537482 | Robert Louis Lee | Family Medicine | 805 Hill Blvd, Ste 103, Granbury, TX 76048-1482 | 2006-10-04 |
| 1245698828 | Lauren Michelle Amburgey | Physician Assistant | 805 Hill Blvd, Suite #102, Granbury, TX 76048-1481 | 2016-02-10 |
| 1336442086 | Nucardio Heart Center | Clinic/Center | 805 Hill Blvd, Suite 106, Granbury, TX 76048-1481 | 2010-12-17 |
| 1245550839 | Depot Bay,inc | Clinic/Center | 805 Hill Blvd, Suite 106, Granbury, TX 76048-1481 | 2010-06-04 |
| 1366777625 | Ntkc-dfw, Pllc | Internal Medicine | 805 Hill Blvd, Suite 102, Granbury, TX 76048-1481 | 2009-10-05 |
| 1063654515 | Ntkc Management, LLC | Internal Medicine | 805 Hill Blvd, Suite 102, Granbury, TX 76048-1481 | 2009-03-30 |
| 1881850378 | Advanced Medical Enterprises Lp | Durable Medical Equipment & Medical Supplies | 805 Hill Blvd, Suite 107, Granbury, TX 76048-1481 | 2008-08-04 |
| 1396934147 | Granbury Family Med Clinic | Clinic/Center | 805 Hill Blvd, Suite 103, Granbury, TX 76048-1482 | 2007-10-17 |
| 1275720765 | Nocturna of Granbury, Lp | Clinic/Center | 805 Hill Blvd, Suite 107, Granbury, TX 76048-1481 | 2007-09-27 |
| 1184765901 | Select Physical Therapy Texas Limited Partnership | Clinic/Center | 805 Hill Blvd, Granbury, TX 76048-1481 | 2007-02-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689213415 | Tena Lee Wood I | Licensed Practical Nurse | 302 S. Crites Granbury Tx. 76048, 302 S. Crites Granbury Tx. 76048, Granbury, TX 76048 | 2019-12-26 |
| 1811456593 | Laura Nicole Graham | Counselor | 2101 West Pearl Street, Granbury, TX 76048 | 2019-03-13 |
| 1477000974 | Globalrehab - Fort Worth, Lp | Rehabilitation Hospital | 805 Hill Blve, Ste 109, Granbury, TX 76048 | 2016-09-01 |
| 1780130245 | Rachel Diane Rouse | Counselor | 1903 W Pearl Street, Granbury, TX 76048 | 2016-08-25 |
| 1477946648 | Adriana Brown | Nurse Practitioner | 805 Hill Blvd., #104, Granbury, TX 76048 | 2015-03-12 |
| 1407261233 | Rogers King Coleman | General Practice | 1411 Crawford Street, Granbury, TX 76048 | 2014-07-01 |
| 1891115176 | Trinity Nursing and Rehabilitation of Granbury, Lp | Skilled Nursing Facility | 600 Reunion Court, Granbury, TX 76048 | 2014-04-24 |
| 1639507122 | Kayelen Helton | Counselor | 807 Paluxy Road, Granbury, TX 76048 | 2013-10-22 |
| 1013257799 | Pecan Valley Mhmr Region | Counselor | 2101 W. Pearl St., Granbury, TX 76048 | 2013-02-18 |
| 1114240223 | Talbot Green Mccormick Jr. | General Practice | 2306 Cologne Dr., Granbury, TX 76048 | 2010-03-03 |
| Find all providers in zip 76048 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871675348 | Lisa Blair | Physician Assistant | 1310 B Paluxy Road, Suite 2000, Granbury, TX 76048 | 2006-10-20 |
| 1932183464 | Charles Darren Rape | Physician Assistant | 1308 Paluxy Rd Ste 203e, Granbury, TX 76048-5689 | 2005-11-29 |
| 1780681486 | John Everett Carter | Physician Assistant | 2200 James Rd, Granbury, TX 76049-8207 | 2005-07-07 |
| 1497370381 | Bethany Lyn Dempsey | Physician Assistant | 805 Hill Blvd Unit 104, Granbury, TX 76048-1482 | 2020-06-16 |
| 1265057632 | Justin Burns | Physician Assistant | 805 Hill Blvd Unit 104, Granbury, TX 76048-1482 | 2020-06-11 |
| 1447600333 | Crissie Alayne Brock | Physician Assistant | 2800 Village Rd, # 108, Granbury, TX 76049-4193 | 2016-06-21 |
| 1245698828 | Lauren Michelle Amburgey | Physician Assistant | 805 Hill Blvd, Suite #102, Granbury, TX 76048-1481 | 2016-02-10 |
| 1740502608 | Michelle Yvonne Singh | Physician Assistant | 805 Hill Blvd Unit 104, Granbury, TX 76048-1482 | 2010-02-19 |
| 1346491446 | Jennifer D Erwin | Physician Assistant | 1209 Medical Plaza Ct, Granbury, TX 76048-5684 | 2008-10-07 |
| 1407006117 | Philip Oran Adams | Physician Assistant | 1310 Paluxy Rd, Granbury, TX 76048-5655 | 2008-09-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.