Provider Demographics
NPI:1104034594
Name:CHAPA, HOMERO JAVIER (MD)
Entity Type:Individual
Prefix:DR
First Name:HOMERO
Middle Name:JAVIER
Last Name:CHAPA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3422 FM 2859
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75109-0797
Mailing Address - Country:US
Mailing Address - Phone:903-872-2873
Mailing Address - Fax:
Practice Address - Street 1:3422 FM 2859
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75109-0797
Practice Address - Country:US
Practice Address - Phone:903-872-2873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD15772085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology