Basic Information
Provider Information
NPI: 1598727844
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAFFER
FirstName: SHELDON
MiddleName:  
NamePrefix: DR.
NameSuffix: II
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1507 W MAIN ST
Address2:  
City: GATESVILLE
State: TX
PostalCode: 765281024
CountryCode: US
TelephoneNumber: 2548652166
FaxNumber:  
Practice Location
Address1: 1507 W MAIN ST
Address2:  
City: GATESVILLE
State: TX
PostalCode: 765281024
CountryCode: US
TelephoneNumber: 2548652166
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/03/2006
LastUpdateDate: 03/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RN0300XL3937TXY Allopathic & Osteopathic PhysiciansInternal MedicineNephrology

No ID Information.


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