De La Vega, Melissa Chavira

De La Vega, Melissa Chavira is an individual health care provider with primary practice located at 1300 S University Dr , Fort Worth TX 76107-5737. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. De La Vega, Melissa Chavira can be contacted via phone (682) 885-1050.

Contact Information

Primary practice address
1300 S University Dr Fort Worth TX 76107-5737
Phone: (682) 885-1050
Fax: (682) 885-7572
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 797788 Texas

Profile Details

NPI number 1376829051
LBN Legal business name De La Vega, Melissa Chavira
Credentials PMHNP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2011
Last updated Apr 3rd, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376829051 NPPES
Texas MEDICAID 287585801
Texas Other 287585802

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