Provider Demographics
NPI:1871203836
Name:CHAVEZ, DANIEL (RD, LD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:CHAVEZ
Suffix:
Gender:M
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8623 N LOOP DR STE B
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79907-4520
Mailing Address - Country:US
Mailing Address - Phone:915-316-1510
Mailing Address - Fax:915-444-5112
Practice Address - Street 1:8623 N LOOP DR STE B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79907-4520
Practice Address - Country:US
Practice Address - Phone:915-316-1510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-30
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT87704133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered