MEDICARE: DIANA TAMEZ CHAVEZ RN, FNP-C

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	363LF0000X	Family Nurse Practitioner	625940	TX

General Provider Information

NPI Number	:	1871714790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA TAMEZ CHAVEZ RN, FNP-C

Provider Business Mailing Address
First Line	:	2120 FORDHAM AVE
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-5714
Country	:	US
Telephone Number	:	956-630-1361
Fax Number	:

Provider Business Practice Location Address
First Line	:	2108 S M ST STE 4
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78503-1556
Country	:	US
Telephone Number	:	956-686-8100
Fax Number	:	956-686-8999

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

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	10/11/2007

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