Provider Demographics
NPI:1619232014
Name:CHAVEZ, CHRISTOPHER M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:M
Last Name:CHAVEZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 BROADBENT PKWY NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-1620
Mailing Address - Country:US
Mailing Address - Phone:505-639-5857
Mailing Address - Fax:505-639-5888
Practice Address - Street 1:2820 BROADBENT PKWY NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-1620
Practice Address - Country:US
Practice Address - Phone:505-639-5857
Practice Address - Fax:505-639-5888
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00007838183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist