Herman Eugene Chavez
Individual provider Active NPI Private Vehicle · Newcomb, NM
NPI 1750143616 · NPPES record last updated Jan 26, 2024
Key facts
- NPI
- 1750143616
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Private Vehicle 347C00000X
- License
- 506289451 (NM)
- Practice address
- 7450 Skyhawk LP
Newcomb, NM 87455 - Phone
- (505) 463-8207
- NPI assigned
- Jan 26, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 506289451 | NM | MD | Private Vehicle |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | 506289451 | NM | Yes |
Addresses
Primary practice location
7450 Skyhawk LP
Newcomb, NM 87455
Mailing address
2495 Parklane Dr
Bosque Farms, NM 87068-9397
Phone (505) 463-8207
Other providers in Newcomb, NM
All providers in Newcomb, NM · Private Vehicle in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 26, 2024. 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.