Basic Information
| Provider Information | |||||||||
| NPI: | 1740642891 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHAVEZ | ||||||||
| FirstName: | KATIA | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD MPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 UNIVERSITY OF NEW MEXICO MSC 10-5610 | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871310001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052726120 | ||||||||
| FaxNumber: | 5052726125 | ||||||||
| Practice Location | |||||||||
| Address1: | 2211 LOMAS BLVD NE | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871062719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052726120 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2016 | ||||||||
| LastUpdateDate: | 04/16/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 35.140734 | OH | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | MD2021-0254 | NM | N | Allopathic & Osteopathic Physicians | Ophthalmology | 208D00000X | 35.140734 | OH | N | Allopathic & Osteopathic Physicians | General Practice | 208D00000X | ME145600 | FL | N | Allopathic & Osteopathic Physicians | General Practice | 207W00000X | ME145600 | FL | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.