Provider Demographics
NPI:1093558058
Name:CHAHBANDAR, SNNA KHALED
Entity type:Individual
Prefix:
First Name:SNNA
Middle Name:KHALED
Last Name:CHAHBANDAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1667 W CAMPBELL RD APT 5209
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-2353
Mailing Address - Country:US
Mailing Address - Phone:727-276-3533
Mailing Address - Fax:
Practice Address - Street 1:1667 W CAMPBELL RD APT 5209
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-2353
Practice Address - Country:US
Practice Address - Phone:727-276-3533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT89940133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered