Provider Demographics
NPI:1245422955
Name:CHANDRASHEKHAR, RAVINDRA (MD)
Entity type:Individual
Prefix:DR
First Name:RAVINDRA
Middle Name:
Last Name:CHANDRASHEKHAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1292
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-1207
Mailing Address - Country:US
Mailing Address - Phone:469-501-2224
Mailing Address - Fax:877-409-1532
Practice Address - Street 1:2008 E HEBRON PKWY STE 100
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-1601
Practice Address - Country:US
Practice Address - Phone:469-501-2224
Practice Address - Fax:877-409-1532
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ7024207R00000X, 207RS0012X
CAA100759207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA100759OtherCALIFORNIA
CAA100759OtherCALIFORNIA