Provider Demographics
NPI:1245253434
Name:CHAVEZ, VICTOR SOSTENES (MD)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:SOSTENES
Last Name:CHAVEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5015 UNIVERSITY AVE UNIT B1
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79413-4427
Mailing Address - Country:US
Mailing Address - Phone:806-797-4357
Mailing Address - Fax:806-797-0124
Practice Address - Street 1:5015 UNIVERSITY AVE UNIT B1
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413-4427
Practice Address - Country:US
Practice Address - Phone:806-797-4357
Practice Address - Fax:806-797-0124
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC8159546207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF0150Medicare UPIN