1780868257 NPI number — BEN CHAVEZ, M.D.,P.A.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780868257 NPI number — BEN CHAVEZ, M.D.,P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEN CHAVEZ, M.D.,P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1780868257
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/19/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5704 SW 50TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AMARILLO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79109-5710
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-350-7671
Provider Business Mailing Address Fax Number:
806-331-2403

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3501 S SONCY RD
Provider Second Line Business Practice Location Address:
SUITE 134
Provider Business Practice Location Address City Name:
AMARILLO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79119-6407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-331-2400
Provider Business Practice Location Address Fax Number:
806-331-2403
Provider Enumeration Date:
12/19/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CHAVEZ
Authorized Official First Name:
BEN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
806-331-2400

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  J6089 , 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)