Provider Demographics
NPI:1487876777
Name:FRANCES CHAVEZ MD LLC
Entity type:Organization
Organization Name:FRANCES CHAVEZ MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNWER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-983-9366
Mailing Address - Street 1:435 SAINT MICHAELS DR
Mailing Address - Street 2:SUITE B203
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-7672
Mailing Address - Country:US
Mailing Address - Phone:505-983-9366
Mailing Address - Fax:505-983-0661
Practice Address - Street 1:435 SAINT MICHAELS DR
Practice Address - Street 2:SUITE B203
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7672
Practice Address - Country:US
Practice Address - Phone:505-983-9366
Practice Address - Fax:505-983-0661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2001-22261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM82779228Medicaid
H56134Medicare UPIN