Provider Demographics
NPI:1992438360
Name:CHAND MEDICAL PRACTICE PROFESSIONAL LIMITED LIABILITY COMPANY
Entity type:Organization
Organization Name:CHAND MEDICAL PRACTICE PROFESSIONAL LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KISHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-304-2769
Mailing Address - Street 1:PO BOX 3954
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77903-3954
Mailing Address - Country:US
Mailing Address - Phone:573-307-0500
Mailing Address - Fax:888-371-0337
Practice Address - Street 1:2700 CITIZENS PLZ STE 101
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-5756
Practice Address - Country:US
Practice Address - Phone:419-304-2769
Practice Address - Fax:888-371-0337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty