Healthcare Provider Details

I. General information

NPI: 1710026596
Provider Name (Legal Business Name): JORGE ADRIAN DE LA CHAPA D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6002 S STAPLES ST
CORPUS CHRISTI TX
78413-2902
US

IV. Provider business mailing address

6002 S STAPLES ST
CORPUS CHRISTI TX
78413-2902
US

V. Phone/Fax

Practice location:
  • Phone: 361-334-2625
  • Fax: 361-334-2203
Mailing address:
  • Phone: 361-334-2625
  • Fax: 361-334-2203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberK9252
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: