Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | L7329 | TX |
Y | 2080P0203X | Pediatric Critical Care Doctor | L7329 | TX |
NPI | 1003870338 |
---|---|
Provider Name | Pedro Nelson Chavez |
First Address | Houston, TX 77210-4346 |
Second Address | San Antonio, TX 78258-3913 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 28/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H36167 | (02) |