Healthcare Provider Details

I. General information

NPI: 1821080862
Provider Name (Legal Business Name): FRANCES LOUISE CHAVEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 11/24/2020
Certification Date: 11/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9837 US HWY 550
CUBA NM
87013-0638
US

IV. Provider business mailing address

3450 ZAFARANO DR UNIT C
SANTA FE NM
87507-2669
US

V. Phone/Fax

Practice location:
  • Phone: 575-289-3291
  • Fax: 575-289-3648
Mailing address:
  • Phone: 575-289-3291
  • Fax: 575-289-3648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2001-22
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: