Provider Demographics
NPI:1942366455
Name:CHAVES, ELGA ENID (OD)
Entity Type:Individual
Prefix:DR
First Name:ELGA
Middle Name:ENID
Last Name:CHAVES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:PO BOX 5140
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-5140
Mailing Address - Country:US
Mailing Address - Phone:787-896-7021
Mailing Address - Fax:787-896-7041
Practice Address - Street 1:4100 AVE ARCADIO ESTRADA
Practice Address - Street 2:SAN SEBASTIAN SHOPPING CENTER
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-3216
Practice Address - Country:US
Practice Address - Phone:787-896-7021
Practice Address - Fax:787-896-7041
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR376152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist