Provider Demographics
NPI:1215603485
Name:CHAVEZ, AMBER RENEE (OTR/L)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:RENEE
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3305 HERON AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-5034
Mailing Address - Country:US
Mailing Address - Phone:956-342-5582
Mailing Address - Fax:
Practice Address - Street 1:208 STARR ST STE 2
Practice Address - Street 2:
Practice Address - City:MERCEDES
Practice Address - State:TX
Practice Address - Zip Code:78570-2736
Practice Address - Country:US
Practice Address - Phone:956-514-1551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122023225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist