Basic Information
| Provider Information | |||||||||
| NPI: | 1881671691 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHAPA | ||||||||
| FirstName: | YVETTE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.D.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6300 WEST LOOP S STE 650 | ||||||||
| Address2: | |||||||||
| City: | BELLAIRE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774012997 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7136637960 | ||||||||
| FaxNumber: | 7133498027 | ||||||||
| Practice Location | |||||||||
| Address1: | 3655 FREDERICKSBURG RD STE 112 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782013859 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2107339990 | ||||||||
| FaxNumber: | 2107331878 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/22/2005 | ||||||||
| LastUpdateDate: | 07/12/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 18781 | TX | Y | Dental Providers | Dentist |
ID Information
| ID | Type | State | Issuer | Description | 007884203 | 05 | TX | MEDICAID |