Provider Demographics
NPI:1306401518
Name:CHAVEZ, MAUREEN K (MD)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:K
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 UNIVERSITY BLVD RM 3.230
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0354
Mailing Address - Country:US
Mailing Address - Phone:409-747-0534
Mailing Address - Fax:409-747-0071
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-1119
Practice Address - Country:US
Practice Address - Phone:409-772-3695
Practice Address - Fax:409-772-3680
Is Sole Proprietor?:No
Enumeration Date:2019-05-02
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXBP10067126208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics