Basic Information
Provider Information
NPI: 1568483022
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAPA
FirstName: HECTOR
MiddleName: OSBALDO
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8441 STATE HIGHWAY 47 STE 3115
Address2:  
City: BRYAN
State: TX
PostalCode: 778073207
CountryCode: US
TelephoneNumber: 9797768440
FaxNumber: 9794360072
Practice Location
Address1: 2900 E 29TH ST
Address2:  
City: BRYAN
State: TX
PostalCode: 778022622
CountryCode: US
TelephoneNumber: 9797768440
FaxNumber: 8776015854
Other Information
ProviderEnumerationDate: 07/21/2006
LastUpdateDate: 06/21/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/21/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XK4653TXY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

ID Information
IDTypeStateIssuerDescription
1Q484401 PTANOTHER
9254060305TX MEDICAID


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