Provider Demographics
NPI:1699086991
Name:CHAVEZ-GELO, EDNA MELINA (MD)
Entity type:Individual
Prefix:
First Name:EDNA
Middle Name:MELINA
Last Name:CHAVEZ-GELO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4329 DONNYBROOK PL
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-1312
Mailing Address - Country:US
Mailing Address - Phone:915-929-8521
Mailing Address - Fax:
Practice Address - Street 1:4329 DONNYBROOK PL
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-1312
Practice Address - Country:US
Practice Address - Phone:915-929-8521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6215207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00967088OtherMEDICARE RAILROAD
TX216753802Medicaid
TXP00967088OtherMEDICARE RAILROAD