Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Chanida K Supavong, DO

Individual provider Family Medicine Physician · NPI 1750672218

Chanida K Supavong, DO is a Family Medicine Physician in Fort Worth, Texas. Licensed in Texas. Registered with an NPI since 2011.

Licensed in
TX
In the registry since
2011
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

5450 Clearfork Main St Ste 460
Fort Worth, TX 76109
Phone: (817) 423-5121
Fax: (817) 423-5122
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence P5896 (TX)

Record details

NPI number1750672218
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedMay 2, 2011
Last updated in NPPESJuly 25, 2018
Mailing address5450 Clearfork Main St Ste 460, Fort Worth, TX 76109-3560

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