Healthcare Provider Details

I. General information

NPI: 1407201221
Provider Name (Legal Business Name): AMANDA CHAVEZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2016
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17510 W GRAND PKWY S STE 310
SUGAR LAND TX
77479-2648
US

IV. Provider business mailing address

4800 W PANTHER CREEK DR STE 100
THE WOODLANDS TX
77381-2568
US

V. Phone/Fax

Practice location:
  • Phone: 713-338-6410
  • Fax:
Mailing address:
  • Phone: 281-364-8600
  • Fax: 281-298-2005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberS1998
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: