Provider Demographics
NPI:1821480666
Name:CHAVEZ, TOMAS ACEVEDO (DO)
Entity Type:Individual
Prefix:DR
First Name:TOMAS
Middle Name:ACEVEDO
Last Name:CHAVEZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 E TANGERINE RD STE 315
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85755-6222
Mailing Address - Country:US
Mailing Address - Phone:520-901-6350
Mailing Address - Fax:
Practice Address - Street 1:1521 E TANGERINE RD STE 315
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755-6222
Practice Address - Country:US
Practice Address - Phone:520-901-6350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014033463207Q00000X
NY275096207Q00000X
AZ006453207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine