Individual
MR. JASON DAVID CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1111 BARRANCA DR, SUITE 700, EL PASO, TX 79935-5004
(915) 591-3130
(915) 591-3136
Mailing address
601 SANDIA VIEW RD NW, LOS RANCHOS, NM 87107-5836
(505) 250-0347
(505) 341-9245
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
1008207
NM
Other
Enumeration date
10/04/2011
Last updated
10/04/2011
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