Healthcare Provider Details

I. General information

NPI: 1114850229
Provider Name (Legal Business Name): ANNA MARIE CHAVEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8940 FOURWINDS DR FL 1
WINDCREST TX
78239-1958
US

IV. Provider business mailing address

8023 CARBON PATH
SAN ANTONIO TX
78250-3510
US

V. Phone/Fax

Practice location:
  • Phone: 830-483-2476
  • Fax:
Mailing address:
  • Phone: 210-872-6997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number99744
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: