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General NPI Number Information
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NPI Number | 1760809917
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Entity Type | Organization
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Legal Business Name | JUSTIN CHAVEZ, MD, PA
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Dates
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Enumeration Date | 03/26/2014
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Last Update Date | 09/20/2024
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Provider Practice Location Address
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Address Line | 351 SETON PKWY
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City | ROUND ROCK
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State | TX
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Zip | 78665-8001
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Country | US
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Telephone | 737-708-9800
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Fax |
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Provider Business Mailing Address
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Address Line | 4500 WILLIAMS DR. STE 212, BOX 163
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City | GEORGETOWN
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State | TX
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Zip | 78633-1329
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Country | US
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Telephone | 737-708-9800
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JUSTIN C. CHAVEZ
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Credential | MD
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Telephone | 512-796-3624
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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