Provider Demographics
NPI:1316750656
Name:VAZQUEZ CHAPA, EDUARDO (DMD)
Entity type:Individual
Prefix:
First Name:EDUARDO
Middle Name:
Last Name:VAZQUEZ CHAPA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 S MARION ST APT G
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-0148
Mailing Address - Country:US
Mailing Address - Phone:832-540-5549
Mailing Address - Fax:
Practice Address - Street 1:2105 S MARION ST APT G
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-0148
Practice Address - Country:US
Practice Address - Phone:832-540-5549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program