Provider Demographics
NPI:1518480904
Name:CHAVEZ, CASSIDY CHRISTINE (NP)
Entity type:Individual
Prefix:
First Name:CASSIDY
Middle Name:CHRISTINE
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 PELICAN AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-4275
Mailing Address - Country:US
Mailing Address - Phone:956-624-6703
Mailing Address - Fax:
Practice Address - Street 1:701 W. NOLANA LOOP
Practice Address - Street 2:STE 5A
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577
Practice Address - Country:US
Practice Address - Phone:956-601-0275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134534363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily