MEDICARE: MICHELLE A CHAVEZ MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	66063	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538481049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE A CHAVEZ MA

Provider Business Mailing Address
First Line	:	102 ROANOKE DR
Second Line	:
City	:	VICTORIA
State	:	TX
Zip	:	77904-2581
Country	:	US
Telephone Number	:	361-485-0755
Fax Number	:	361-894-7450

Provider Business Practice Location Address
First Line	:	5606 N NAVARRO ST
Second Line	:	SUITE 202
City	:	VICTORIA
State	:	TX
Zip	:	77904-1727
Country	:	US
Telephone Number	:	361-485-0755
Fax Number	:	361-894-7450

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2010
Last Update Date	:	04/25/2016

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Directions to “ MICHELLE A CHAVEZ MA” Practice Location

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