Provider Demographics
NPI:1245565753
Name:CHAVARRO, JORGE (SA-C)
Entity Type:Individual
Prefix:MR
First Name:JORGE
Middle Name:
Last Name:CHAVARRO
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 130908
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77393-0908
Mailing Address - Country:US
Mailing Address - Phone:281-653-2924
Mailing Address - Fax:832-478-9266
Practice Address - Street 1:8101 RESEARCH FOREST DR
Practice Address - Street 2:11108
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-1502
Practice Address - Country:US
Practice Address - Phone:281-653-2924
Practice Address - Fax:832-478-9266
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-16
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant