Individual
PRAVEEN CHAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
42121 US HWY 70, PORTALES, NM 88130-9347
(575) 356-6652
(575) 359-6827
Mailing address
PO BOX 299, PORTALES, NM 88130-0299
(575) 356-6652
(575) 359-6827
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD2013-0397
NM
207Q00000X
Family Medicine Physician
N8280
TX
Other
Enumeration date
09/16/2011
Last updated
10/11/2013
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