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General NPI Number Information
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NPI Number | 1477725026
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Entity Type | Organization
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Legal Business Name | TLC RHEUMATOLOGY
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Dates
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Enumeration Date | 03/24/2008
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Last Update Date | 03/24/2008
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Provider Practice Location Address
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Address Line | 896 W NYE LN SUITE 204
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City | CARSON CITY
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State | NV
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Zip | 89703-1544
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Country | US
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Telephone | 775-885-2099
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Fax | 775-885-2288
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Provider Business Mailing Address
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Address Line | 896 W NYE LN SUITE 204
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City | CARSON CITY
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State | NV
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Zip | 89703-1544
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Country | US
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Telephone | 775-885-2099
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Fax | 775-885-2288
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Authorized Official
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Title or Position | OWNER
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Name | DR. TERESA LYNN CHAVEZ
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Credential | M.D.
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Telephone | 775-885-2099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 8361
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License Number State | NV
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