Provider Demographics
NPI:1689645913
Name:CHAVEZ, ALFREDO (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFREDO
Middle Name:
Last Name:CHAVEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 N OREGON
Mailing Address - Street 2:STE 1A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-3528
Mailing Address - Country:US
Mailing Address - Phone:915-532-2445
Mailing Address - Fax:915-532-2673
Practice Address - Street 1:1600 N OREGON
Practice Address - Street 2:STE 1A
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3528
Practice Address - Country:US
Practice Address - Phone:915-532-2445
Practice Address - Fax:915-532-2673
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5081207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G59924Medicare UPIN
8523K2Medicare ID - Type Unspecified