ETHAN THOMAS CHAVEZ (NPI# 1336780584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336780584 |
| Entity Type | Individual |
| Full Name | ETHAN THOMAS CHAVEZ |
| Practice Address |
309 Homestead Ave Apt 1803 Lubbock TX 79416-1753 |
| Mailing Address |
2407 N Frankford Ave Lubbock TX 79416-9643 |
| Practice Telephone | 8062838100 |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2019-09-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
309 HOMESTEAD AVE APT 1803 |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79416-1753 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710502174 | Jordan Lane Thompson | Pharmacist | 6313 4th Street, Lubbock, TX 79416 | 2020-06-11 |
| 1821636481 | Chieh-an Chou | Specialist/Technologist | 201 N Winston Ave, Lubbock, TX 79416 | 2019-12-13 |
| 1790341949 | Michael Mcpherson, M.d. P.a. | Internal Medicine | 5406 Colgate St, Lubbock, TX 79416 | 2019-05-14 |
| 1154893675 | South Plains Rehabilitation Hospital, LLC | Rehabilitation Hospital | 5406 Colgate Street, Lubbock, TX 79416 | 2018-12-21 |
| 1932697182 | Timothy Sampana | Student in an Organized Health Care Education/Training Program | 5217 Lehigh St, Lubbock, TX 79416 | 2018-04-24 |
| 1306347711 | 4th Street Dental, Pllc | Dentist | 5709 4th St, Lubbock, TX 79416 | 2018-02-22 |
| 1639682503 | South Plains Surgery Center LLC | Clinic/Center | 4412 6th Street, Lubbock, TX 79416 | 2017-11-14 |
| 1013459809 | Isabel Garcia | Occupational Therapy Assistant | 1717 Northfolk Ave, #a, Lubbock, TX 79416 | 2016-11-09 |
| 1033589213 | Rehab Care | Skilled Nursing Facility | 1717 Norfork Ave, Bldg A, Lubbock, TX 79416 | 2015-10-01 |
| 1902281306 | Carrillon | Clinic/Center | 1717 Norfold Bld A, Lubbock, TX 79416 | 2015-07-27 |
| Find all providers in zip 79416 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427674399 | Nicole Lynn Rosteski | Student in an Organized Health Care Education/Training Program | 3101 96th St, Lubbock, TX 79423 | 2020-06-17 |
| 1942824214 | Kaka Leigh Adams | Student in an Organized Health Care Education/Training Program | 3601 4th St Ttuhsc Dept-pediatrics, Lubbock, TX 79430-0001 | 2020-06-03 |
| 1104440403 | Nadia Tello | Student in an Organized Health Care Education/Training Program | 3601 4th St Stop 8315, Lubbock, TX 79430-8315 | 2020-06-02 |
| 1154945517 | Nicholas Quigley | Student in an Organized Health Care Education/Training Program | Ttuhsc 3601 4th Street Stop 6211, Lubbock, TX 79430-0001 | 2020-06-02 |
| 1265056683 | Chandon C Loya | Student in an Organized Health Care Education/Training Program | Family Medicine Residency Program Ttu Hsc, 3601 4th Street Mail Stop 8143, Lubbock, TX 79430-0001 | 2020-06-01 |
| 1659995256 | Joshua Daniel Brogan | Student in an Organized Health Care Education/Training Program | Internal Med Dept Lbk Genl 3601 4th St Stop 9410, Lubbock, TX 79430-9410 | 2020-05-31 |
| 1932722873 | Aron Tidrick | Student in an Organized Health Care Education/Training Program | 3601 4th St Rm 1b350, Lubbock, TX 79430-0002 | 2020-05-27 |
| 1730702473 | Emily Bouffard | Student in an Organized Health Care Education/Training Program | 3601 4th Street Mail Stop 8143, Lubbock, TX 79430 | 2020-05-27 |
| 1235752098 | Shannon Corbitt | Student in an Organized Health Care Education/Training Program | 3601 Fourth Street Ttuhsc Department of Surgery Ms 8312, Lubbock, TX 79430-0001 | 2020-05-27 |
| 1104449917 | Jacob Burton | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology 3601 4th St Ms 8182 1b350b, Lubbock, TX 79430-8182 | 2020-05-27 |
| Find all providers in LUBBOCK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.