1386758993 NPI number — MR. HARRY L CHAVEZ MD

Table of content: MR. HARRY L CHAVEZ MD (NPI 1386758993)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386758993 NPI number — MR. HARRY L CHAVEZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAVEZ
Provider First Name:
HARRY
Provider Middle Name:
L
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386758993
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/02/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1303 HOSPITAL BLVD
Provider Second Line Business Mailing Address:
P.O. BOX 40
Provider Business Mailing Address City Name:
FLORESVILLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78114
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
830-393-3114
Provider Business Mailing Address Fax Number:
830-216-2832

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1303 HOSPITAL BLVD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLORESVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78114
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-393-3114
Provider Business Practice Location Address Fax Number:
830-216-2832
Provider Enumeration Date:
08/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  F8050 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 126292501 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1262925-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 126292504 . This is a "MEDICAID HEALTH STEPS NO" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com