Provider Demographics
NPI:1073398707
Name:CHAPA, OFELIA CAVAZOS
Entity Type:Individual
Prefix:
First Name:OFELIA
Middle Name:CAVAZOS
Last Name:CHAPA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8333 DOUGLAS AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-5845
Mailing Address - Country:US
Mailing Address - Phone:214-471-5189
Mailing Address - Fax:
Practice Address - Street 1:8333 DOUGLAS AVE STE 350
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5802
Practice Address - Country:US
Practice Address - Phone:214-471-5189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92697101YP2500X
TX16440101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional