Provider Demographics
NPI:1922096080
Name:CHAVEZ, ARMANDO (MD)
Entity Type:Individual
Prefix:
First Name:ARMANDO
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 1:11040 EAST FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77029-1931
Mailing Address - Country:US
Mailing Address - Phone:713-451-5935
Mailing Address - Fax:713-451-5451
Practice Address - Street 1:11040 EAST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77029-1931
Practice Address - Country:US
Practice Address - Phone:713-451-5935
Practice Address - Fax:713-451-5451
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-12
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8487207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092184303Medicaid
G16043Medicare UPIN
TX092184303Medicaid