Provider Demographics
NPI:1598277378
Name:DECHAVEZ, JAMES ELIEZER (FNP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ELIEZER
Last Name:DECHAVEZ
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E FM 1187
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-4358
Mailing Address - Country:US
Mailing Address - Phone:817-568-2023
Mailing Address - Fax:817-568-2738
Practice Address - Street 1:901 E FM 1187
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-4358
Practice Address - Country:US
Practice Address - Phone:817-568-2023
Practice Address - Fax:817-568-2738
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-01
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134848363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX720306OtherMEDICARE
TX1598277378Medicaid