Provider Demographics
NPI:1841046265
Name:CHAVEZ, DESI
Entity type:Individual
Prefix:
First Name:DESI
Middle Name:
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 CRYSTAL FALLS PKWY UNIT 8
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-3672
Mailing Address - Country:US
Mailing Address - Phone:512-986-7625
Mailing Address - Fax:281-254-7897
Practice Address - Street 1:800 CRYSTAL FALLS PKWY UNIT 8
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-3672
Practice Address - Country:US
Practice Address - Phone:512-986-7625
Practice Address - Fax:281-254-7897
Is Sole Proprietor?:No
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6319103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst