Provider Demographics
NPI:1962798322
Name:CHAPA, PEDRO JR (CONTRACTOR)
Entity type:Individual
Prefix:MR
First Name:PEDRO
Middle Name:
Last Name:CHAPA
Suffix:JR
Gender:M
Credentials:CONTRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5462 WALE ST
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-9751
Mailing Address - Country:US
Mailing Address - Phone:956-533-3751
Mailing Address - Fax:956-716-6561
Practice Address - Street 1:5462 WALE ST
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-9751
Practice Address - Country:US
Practice Address - Phone:956-533-3751
Practice Address - Fax:956-716-6561
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor