Provider Demographics
NPI:1225514920
Name:CHAPA, DESIREE NICOLE (OD)
Entity Type:Individual
Prefix:DR
First Name:DESIREE
Middle Name:NICOLE
Last Name:CHAPA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 INDEPENDENCE DR APT 1310
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-0050
Mailing Address - Country:US
Mailing Address - Phone:956-650-2995
Mailing Address - Fax:
Practice Address - Street 1:2251 FM 1103 STE 126
Practice Address - Street 2:
Practice Address - City:CIBOLO
Practice Address - State:TX
Practice Address - Zip Code:78108-4084
Practice Address - Country:US
Practice Address - Phone:956-650-2995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-16
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9486-T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist