Healthcare Provider Details

I. General information

NPI: 1487876777
Provider Name (Legal Business Name): FRANCES CHAVEZ MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 SAINT MICHAELS DR SUITE B203
SANTA FE NM
87505-7672
US

IV. Provider business mailing address

435 SAINT MICHAELS DR SUITE B203
SANTA FE NM
87505-7672
US

V. Phone/Fax

Practice location:
  • Phone: 505-983-9366
  • Fax: 505-983-0661
Mailing address:
  • Phone: 505-983-9366
  • Fax: 505-983-0661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number2001-22
License Number StateNM

VIII. Authorized Official

Name: FRANCES LOUISE CHAVEZ
Title or Position: OWNWER
Credential: M.D.
Phone: 505-983-9366