Provider Demographics
NPI:1366688384
Name:CHAVEZ, RAMON (OTR)
Entity Type:Individual
Prefix:MR
First Name:RAMON
Middle Name:
Last Name:CHAVEZ
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8407 HIDALGO ST
Mailing Address - Street 2:
Mailing Address - City:MONTE ALTO
Mailing Address - State:TX
Mailing Address - Zip Code:78538-3205
Mailing Address - Country:US
Mailing Address - Phone:956-262-3917
Mailing Address - Fax:956-262-7756
Practice Address - Street 1:205 W EDINBURG AVE
Practice Address - Street 2:
Practice Address - City:ELSA
Practice Address - State:TX
Practice Address - Zip Code:78504-1969
Practice Address - Country:US
Practice Address - Phone:956-262-1037
Practice Address - Fax:956-262-7756
Is Sole Proprietor?:No
Enumeration Date:2008-12-22
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112802225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX183477202Medicaid
TX454880Medicare Oscar/Certification