Pedro Ismael Chavez
Individual provider Active NPI Counselor · Chimayo, NM
NPI 1437482015 · NPPES record last updated Sep 14, 2009
Key facts
- NPI
- 1437482015
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- CR 103, Manzana Center, Building 3
Chimayo, NM 87522 - Phone
- (505) 351-1456
- Fax
- (505) 351-1556
- NPI assigned
- Sep 14, 2009
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
CR 103, Manzana Center, Building 3
Chimayo, NM 87522
Mailing address
11 Calle Chiripada
Espanola, NM 87532-9536
Phone (505) 351-1456
Other providers in Chimayo, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.