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General NPI Number Information
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NPI Number | 1962798322
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Entity Type | Individual
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Provider Name | PEDRO CHAPA JR. CONTRACTOR
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Gender | Male
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Dates
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Enumeration Date | 06/23/2011
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Last Update Date | 06/23/2011
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Provider Practice Location Address
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Address Line | 5462 WALE ST
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City | RIO GRANDE CITY
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State | TX
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Zip | 78582-9751
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Country | US
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Telephone | 956-533-3751
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Fax | 956-716-6561
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Provider Business Mailing Address
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Address Line | 5462 WALE ST
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City | RIO GRANDE CITY
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State | TX
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Zip | 78582-9751
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Country | US
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Telephone | 956-533-3751
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Fax | 956-716-6561
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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 | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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