Provider Demographics
NPI:1386693406
Name:CHAUDHARI, NILESHKUMAR M (MD)
Entity type:Individual
Prefix:
First Name:NILESHKUMAR
Middle Name:M
Last Name:CHAUDHARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15015 KIRBY DR STE 200B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77047-2580
Mailing Address - Country:US
Mailing Address - Phone:281-456-4412
Mailing Address - Fax:281-205-8356
Practice Address - Street 1:15015 KIRBY DR STE 200B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77047-2580
Practice Address - Country:US
Practice Address - Phone:281-456-4412
Practice Address - Fax:281-205-8356
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL29226207X00000X, 207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03737319Medicaid
ALP00912096OtherRAILROAD MEDICARE
AL113241Medicaid
AL051049990OtherBCBS
AL051049989OtherBCBS
AL051049988OtherBCBS
AL113235Medicaid
AL113239Medicaid
AL051049990OtherBCBS