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General NPI Number Information
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NPI Number | 1306102439
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Entity Type | Organization
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Legal Business Name | TAMERLA D CHAVIS MD,PA
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Dates
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Enumeration Date | 04/03/2012
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Last Update Date | 04/03/2012
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Provider Practice Location Address
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Address Line | 755 N 11TH ST SUITE P-5500
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City | BEAUMONT
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State | TX
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Zip | 77702-1500
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Country | US
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Telephone | 409-924-8111
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Fax |
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Provider Business Mailing Address
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Address Line | 755 N 11TH ST SUITE P-5500
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City | BEAUMONT
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State | TX
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Zip | 77702-1500
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Country | US
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Telephone | 409-924-8111
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TAMERLA DAWN CHAVIS
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Credential | MD
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Telephone | 409-924-8111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | H4230
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License Number State | TX
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