Healthcare Provider Details

I. General information

NPI: 1467983288
Provider Name (Legal Business Name): JOSEPH CRUZ CHAVARRIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2017
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 COIT RD STE 203
FRISCO TX
75035-0503
US

IV. Provider business mailing address

4401 COIT RD STE 203
FRISCO TX
75035-0503
US

V. Phone/Fax

Practice location:
  • Phone: 972-817-7450
  • Fax: 972-817-7455
Mailing address:
  • Phone: 972-817-7450
  • Fax: 972-817-7455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberU2805
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberU2805
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: