Provider Demographics
NPI:1306167085
Name:CHAVDA, SHITAL P (MD)
Entity type:Individual
Prefix:DR
First Name:SHITAL
Middle Name:P
Last Name:CHAVDA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4214 GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-7904
Mailing Address - Country:US
Mailing Address - Phone:352-514-2269
Mailing Address - Fax:
Practice Address - Street 1:2928 N BELT LINE RD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-5247
Practice Address - Country:US
Practice Address - Phone:214-307-7786
Practice Address - Fax:469-460-9091
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SCMD36123207Q00000X
TXP9437207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP9437OtherTEXAS STATE MEDICAL BOARD