Provider Demographics
NPI:1386265783
Name:CHAVEZ, MEGAN NICOLE (PA-C)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:NICOLE
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 1:3801 N MCCOLL RD APT 725
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-9122
Mailing Address - Country:US
Mailing Address - Phone:956-525-9793
Mailing Address - Fax:
Practice Address - Street 1:3600 N 23RD ST STE 103
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-6081
Practice Address - Country:US
Practice Address - Phone:956-664-9081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-27
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA13536363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty