Healthcare Provider Details

I. General information

NPI: 1497788996
Provider Name (Legal Business Name): ALICE CLAIRE CHAVEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALICE CLAIRE PAYNE MD

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5150 JOURNAL CENTER BLVD NE
ALBUQUERQUE NM
87109
US

IV. Provider business mailing address

800 BRADBURY DR SE STE 116
ALBUQUERQUE NM
87106-4310
US

V. Phone/Fax

Practice location:
  • Phone: 505-254-6500
  • Fax: 505-254-6532
Mailing address:
  • Phone: 505-272-1476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number20050413
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: