Provider Demographics
NPI:1316916125
Name:CHABRA, SANJAY (DO)
Entity type:Individual
Prefix:
First Name:SANJAY
Middle Name:
Last Name:CHABRA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4849 N MESA ST STE 201
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-5919
Mailing Address - Country:US
Mailing Address - Phone:915-351-6600
Mailing Address - Fax:915-351-6601
Practice Address - Street 1:2600 N OREGON ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3170
Practice Address - Country:US
Practice Address - Phone:915-317-1660
Practice Address - Fax:915-320-4848
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXR8538207RR0500X, 207RR0500X
CA20A9459207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3892507-01Medicaid
TX3892507-01Medicaid
AZ940404Medicaid
I27810Medicare UPIN
AZ940404Medicaid