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General NPI Number Information
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NPI Number | 1659669158
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Entity Type | Organization
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Legal Business Name | LOUISA G. CHAVEZ, M.D. PC
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Dates
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Enumeration Date | 07/18/2011
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Last Update Date | 07/18/2011
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Provider Practice Location Address
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Address Line | 4705 MONTGOMERY BLVD NE SUITE 105
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-1226
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Country | US
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Telephone | 505-880-1234
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Fax | 505-727-7667
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Provider Business Mailing Address
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Address Line | 4705 MONTGOMERY BLVD NE SUITE 105
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-1226
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Country | US
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Telephone | 505-880-1234
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Fax | 505-727-7667
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Authorized Official
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Title or Position | OWNER
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Name | LOUISA GAYLE CHAVEZ
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Credential | MD
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Telephone | 505-880-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 91-18
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License Number State | NM
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