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Contact Information

LARRY M CHISM PC
136 SHELLEY DRIVE
TYLER, TX75701
 Phone: 903-561-8686
 Fax: 903-581-1518
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for LARRY M CHISM PC · (Female)

NPI Number 1033247598
Status Active
Credentials
Entity Individual
Enumeration date 02/28/2007
Last updated 05/17/2012 - About 14 years ago
Sole proprietor 1 Not specified
Identifiers
  • TX License # 02774TG
  • TX Other 0006FG BLUECROSSBLUESHIELD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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