Provider Demographics
NPI:1659960169
Name:CHAVEZ, MARIA EUGENIA
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:EUGENIA
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:STEPHENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76401-3928
Mailing Address - Country:US
Mailing Address - Phone:254-965-2267
Mailing Address - Fax:254-965-0832
Practice Address - Street 1:2150 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:STEPHENVILLE
Practice Address - State:TX
Practice Address - Zip Code:76401-3928
Practice Address - Country:US
Practice Address - Phone:254-965-2267
Practice Address - Fax:254-965-0832
Is Sole Proprietor?:No
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician