Provider Demographics
NPI:1689683039
Name:CHAVANA, ANNA LISA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:LISA
Last Name:CHAVANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANNA
Other - Middle Name:LISA
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1210 ARION PKWY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-2880
Mailing Address - Country:US
Mailing Address - Phone:210-653-5501
Mailing Address - Fax:210-650-5975
Practice Address - Street 1:8715 VILLAGE DR
Practice Address - Street 2:SUITE 410
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5405
Practice Address - Country:US
Practice Address - Phone:210-653-5501
Practice Address - Fax:210-650-5975
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7185207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX045625301Medicaid
TX87532KMedicare ID - Type Unspecified
TXH21575Medicare UPIN