Individual
SANTIAGO A CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3811 E BELL RD STE 309, PHOENIX, AZ 85032-2160
(480) 420-0749
(480) 420-0732
Mailing address
3811 E BELL RD STE 309, PHOENIX, AZ 85032-2160
(480) 420-0749
(480) 420-0732
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
TEMPORARY LICENSE
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208169703
—
TX
Enumeration date
10/28/2006
Last updated
09/04/2019
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