Provider Demographics
NPI:1306280342
Name:AGRAWAL, CHARU
Entity type:Individual
Prefix:
First Name:CHARU
Middle Name:
Last Name:AGRAWAL
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:ONE BAYLOR PLAZA, BCM187
Mailing Address - Street 2:HARRIS COUNTY
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4202
Mailing Address - Country:US
Mailing Address - Phone:713-798-4508
Mailing Address - Fax:713-798-3342
Practice Address - Street 1:7200 CAMBRIDGE STREET
Practice Address - Street 2:10TH FLOOR
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4202
Practice Address - Country:US
Practice Address - Phone:713-798-3750
Practice Address - Fax:713-798-4693
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-22
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR4505207R00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty