1770427346 NPI number — ITZEL CHAVARRIA

Table of content: ITZEL CHAVARRIA (NPI 1770427346)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770427346 NPI number — ITZEL CHAVARRIA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAVARRIA
Provider First Name:
ITZEL
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

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:
1770427346
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/15/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7108 SOUTH KANNER HWY, STUART, FL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STUART
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
71083-4997
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
185-583-2672
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
221 N KANSAS ST, SUITE 700 EL PASO, TX 79901
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EL PASO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
185-583-2672
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/15/2026

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: 106S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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