| Chaveli Ezpeleta Licata, AA | |
|
6411 Fannin St, Houston, TX 77030-1501 | |
| (713) 500-6200 | |
| Not Available |
| Full Name | Chaveli Ezpeleta Licata |
|---|---|
| Gender | Female |
| Speciality | Anesthesiology Assistant |
| Experience | 11 Years |
| Location | 6411 Fannin St, Houston, Texas |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114365509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367H00000X | Anesthesiologist Assistant | 1529 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Memorial Hermann - Texas Medical Center | Houston, TX | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ut Physicians | 8426960360 | 1400 |
| Entity Name | Ut Physicians |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033157821 PECOS PAC ID: 8426960360 Enrollment ID: O20031107000268 |
| Mailing Address | Practice Location Address |
|---|---|
| Chaveli Ezpeleta Licata, AA Po Box 301173, Dallas, TX 75303-1173 Ph: (713) 500-3500 | Chaveli Ezpeleta Licata, AA 6411 Fannin St, Houston, TX 77030-1501 Ph: (713) 500-6200 |
James Nast Trahan, AA Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 1500 Citywest Blvd Ste 300, Houston, TX 77042 Phone: 713-620-4000 | |
Caitlyn Marie Kohake, Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 6720 Bertner Ave, Houston, TX 77030 Phone: 823-355-2666 | |
Robert Sean Mcneill, AA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 1500 Citywest Blvd, Ste. 300, Houston, TX 77042 Phone: 713-620-4000 Fax: 713-458-4229 | |
Aleena A Gillani, AA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 1500 Citywest Blvd Ste 300, Houston, TX 77042 Phone: 972-233-1999 Fax: 972-233-3666 | |
Logan Patrick Fettig, Anesthesiologist Assistant Medicare: Not Enrolled in Medicare Practice Location: 6720 Bertner Ave, Houston, TX 77030 Phone: 832-355-2666 | |
Joseph Grant Shafer, AA-C Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 6414 Fannin St, #g125, Houston, TX 77030 Phone: 713-500-6930 Fax: 713-500-5484 | |
Sarah P Her, AA-S Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 1500 Citywest Blvd, Ste. 300, Houston, TX 77042 Phone: 713-620-4000 Fax: 713-458-4229 |