Provider Demographics
NPI:1699733576
Name:CHATTAR-CORA, DEOWALL (MD)
Entity type:Individual
Prefix:DR
First Name:DEOWALL
Middle Name:
Last Name:CHATTAR-CORA
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 1:1931 ROGERS RD STE 104
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4853
Mailing Address - Country:US
Mailing Address - Phone:210-265-1924
Mailing Address - Fax:210-265-3387
Practice Address - Street 1:11212 STATE HIGHWAY 151
Practice Address - Street 2:MEDICAL PLAZA II STE 230
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4498
Practice Address - Country:US
Practice Address - Phone:210-265-1924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3496207P00000X, 208600000X, 2086S0105X, 2086S0122X
NY226264-1208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand