Healthcare Provider Details

I. General information

NPI: 1073830246
Provider Name (Legal Business Name): RICARDO JESUS CHAPA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2010
Last Update Date: 02/02/2023
Certification Date: 01/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27600 RANCH ROAD 12 BLDG 1
DRIPPING SPRINGS TX
78620-5612
US

IV. Provider business mailing address

AUSTIN REGIONAL CLINIC 6210 E US HWY 290
AUSTIN TX
78723
US

V. Phone/Fax

Practice location:
  • Phone: 512-829-9118
  • Fax: 512-406-7901
Mailing address:
  • Phone: 512-829-9118
  • Fax: 512-829-9118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberP6796
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: