Provider Demographics
NPI:1679822407
Name:URBANEK, CHEVON L (NP-C)
Entity Type:Individual
Prefix:
First Name:CHEVON
Middle Name:L
Last Name:URBANEK
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1112
Mailing Address - Street 2:
Mailing Address - City:ELECTRA
Mailing Address - State:TX
Mailing Address - Zip Code:76360-1112
Mailing Address - Country:US
Mailing Address - Phone:940-495-3981
Mailing Address - Fax:940-495-4137
Practice Address - Street 1:405 SE ACCESS RD
Practice Address - Street 2:
Practice Address - City:IOWA PARK
Practice Address - State:TX
Practice Address - Zip Code:76367-6985
Practice Address - Country:US
Practice Address - Phone:940-592-3500
Practice Address - Fax:940-592-4820
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX743384363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily