Provider Demographics
NPI:1366512709
Name:CHANDNI CHOUDHARY MD PA
Entity type:Organization
Organization Name:CHANDNI CHOUDHARY MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-520-3450
Mailing Address - Street 1:1200 BINZ ST STE 400
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-6942
Mailing Address - Country:US
Mailing Address - Phone:713-520-6016
Mailing Address - Fax:713-893-1342
Practice Address - Street 1:1200 BINZ ST STE 400
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-6942
Practice Address - Country:US
Practice Address - Phone:713-520-6016
Practice Address - Fax:713-893-1342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX142431901Medicaid
TX1962765834OtherNPI
TX8MX486OtherTEXAS BCBS
TX1D0157OtherMEDICARE
TX1366512709OtherGROUP NPI