Provider Demographics
NPI:1538566781
Name:CHAVEZ, MARIBEL (PA-C)
Entity type:Individual
Prefix:
First Name:MARIBEL
Middle Name:
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5641 ESPLANADE DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4299
Mailing Address - Country:US
Mailing Address - Phone:361-287-0100
Mailing Address - Fax:
Practice Address - Street 1:5641 ESPLANADE DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4299
Practice Address - Country:US
Practice Address - Phone:361-287-0100
Practice Address - Fax:361-287-0101
Is Sole Proprietor?:No
Enumeration Date:2014-12-02
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA09533363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant