1598744583 NPI number — DR. MONICA SANJAY CHABRA DO

Table of content: LARA LIBRIE MA (NPI 1932608528)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598744583 NPI number — DR. MONICA SANJAY CHABRA DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHABRA
Provider First Name:
MONICA
Provider Middle Name:
SANJAY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HELEKAR
Provider Other First Name:
MONICA
Provider Other Middle Name:
SUDHEER
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1598744583
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/24/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4849 N MESA ST STE 201
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL PASO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79912-5919
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-351-6600
Provider Business Mailing Address Fax Number:
915-351-6600

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1900 DENVER AVE
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:
79902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-544-4000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/10/2006

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: 2084P0800X , with the licence number:  R8167 , 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)