Provider Demographics
NPI:1073398707
Name:CHAPA, OFELIA CAVAZOS
Entity type:Individual
Prefix:
First Name:OFELIA
Middle Name:CAVAZOS
Last Name:CHAPA
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 1:8300 DOUGLAS AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-5826
Mailing Address - Country:US
Mailing Address - Phone:972-752-3462
Mailing Address - Fax:
Practice Address - Street 1:8300 DOUGLAS AVE STE 800
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5826
Practice Address - Country:US
Practice Address - Phone:972-752-3462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-30
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16440101YA0400X
TX92697101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)