Provider Demographics
NPI:1285964098
Name:R. CHANDRASEKHARA M.D.,P.A.
Entity type:Organization
Organization Name:R. CHANDRASEKHARA M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAE
Authorized Official - Middle Name:P
Authorized Official - Last Name:CHANDRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-968-8523
Mailing Address - Street 1:1210 E 8TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-7120
Mailing Address - Country:US
Mailing Address - Phone:956-968-8523
Mailing Address - Fax:956-969-1761
Practice Address - Street 1:1210 E 8TH ST STE 1
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-7120
Practice Address - Country:US
Practice Address - Phone:956-968-8523
Practice Address - Fax:956-969-1761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-30
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE5497207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX089498202Medicaid
TX00AH07Medicare UPIN