Provider Demographics
NPI:1144066127
Name:CHAVEZ, ALEX MIRANDA
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:MIRANDA
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 HIDDEN RDG APT 1123
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-8790
Mailing Address - Country:US
Mailing Address - Phone:915-355-1386
Mailing Address - Fax:
Practice Address - Street 1:1135 HIDDEN RDG APT 1123
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-8790
Practice Address - Country:US
Practice Address - Phone:915-355-1386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist