Provider Demographics
NPI:1053780536
Name:CHAUBURG PLLC
Entity type:Organization
Organization Name:CHAUBURG PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARCELO
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAUVET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-401-8019
Mailing Address - Street 1:1218 FRANKLIN WREN WAY
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-7702
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3051 N ZARAGOZA RD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-7921
Practice Address - Country:US
Practice Address - Phone:915-401-8019
Practice Address - Fax:901-401-8096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-15
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care