Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | S5059 | TX |
NPI | 1164873188 |
---|---|
Provider Name | Humberto Raul Saenz Chavez |
First Address | El Paso, TX 79915-1115 |
Second Address | El Paso, TX 79915-1115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2016 |
Last Update Date | 10/07/2020 |