Provider Demographics
NPI:1326044785
Name:CHAVEZ, ANTONIO F (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:F
Last Name:CHAVEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:801 E PLANO PKWY
Mailing Address - Street 2:STE 100
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-6894
Mailing Address - Country:US
Mailing Address - Phone:972-841-5820
Mailing Address - Fax:972-881-4390
Practice Address - Street 1:801 E PLANO PKWY
Practice Address - Street 2:STE 100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-6894
Practice Address - Country:US
Practice Address - Phone:972-841-5820
Practice Address - Fax:972-881-4390
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2016-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8063207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX101179306Medicaid
TX8A2642Medicare ID - Type Unspecified
TX101179306Medicaid