Healthcare Provider Details

I. General information

NPI: 1881918100
Provider Name (Legal Business Name): ANTONIO ROMO DE VIVAR CHAVEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2010
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5400 ALAMEDA AVE STE A
EL PASO TX
79905-2914
US

IV. Provider business mailing address

7500 VISCOUNT BLVD STE 298
EL PASO TX
79925-5607
US

V. Phone/Fax

Practice location:
  • Phone: 915-521-5400
  • Fax: 915-521-2297
Mailing address:
  • Phone: 915-200-2694
  • Fax: 915-521-1178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberT3375
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number6457-851
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number5404382
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: