Individual
BENNIE CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3113 ROSS ST, AMARILLO, TX 79103-2700
(806) 374-7341
(806) 322-0533
Mailing address
3113 ROSS ST, AMARILLO, TX 79103-2700
(806) 374-7341
(805) 322-0533
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J6089
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8B2862
MEDICARE ID/UNSPECIFIED
TX
01
—
F01241
UPIN
TX
01
—
P00060898
RAILROAD MEDICARE
TX
Enumeration date
07/11/2005
Last updated
06/02/2022
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