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General NPI Number Information
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NPI Number | 1447995733
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Entity Type | Individual
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Provider Name | JUAN JOSE IVAN CHAVEZ JR. MSN-FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 05/01/2022
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 12412 JUDSON RD
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City | LIVE OAK
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State | TX
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Zip | 78233-3255
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Country | US
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Telephone | 210-757-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 6059 CASTLE HUNT
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City | SAN ANTONIO
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State | TX
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Zip | 78218-4116
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Country | US
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Telephone | 956-480-8864
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1078812
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License Number State | TX
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