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Individual

TAMERLA DAWN CHAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
755 N 11TH STREET, SUITE P5500, BEAUMONT, TX 77702
(409) 924-8111
(409) 924-8234
Mailing address
755 N 11TH STREET, SUITE P5500, BEAUMONT, TX 77702
(409) 924-8111
(409) 924-8234

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
H4230
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
030803301
TX
01
140066844
MEDICARE RR
Enumeration date
07/08/2005
Last updated
06/25/2010
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