MEDICARE: LUZ MARIA CHAVEZ IBCLC

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	174N00000X	Lactation Consultant (Non-RN)	L-306740

General Provider Information

NPI Number	:	1760115489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUZ MARIA CHAVEZ IBCLC

Provider Business Mailing Address
First Line	:	2002 DETROIT AVE # B
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-3012
Country	:	US
Telephone Number	:	915-201-9317
Fax Number	:

Provider Business Practice Location Address
First Line	:	2002 DETROIT AVE # B
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-3012
Country	:	US
Telephone Number	:	915-201-9317
Fax Number	:

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

Provider Enumeration Date	:	07/09/2022
Last Update Date	:	07/09/2022

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