Provider Demographics
NPI:1104864859
Name:CHANDRASEKHAR, AMBAT CHITRA (MD)
Entity Type:Individual
Prefix:DR
First Name:AMBAT CHITRA
Middle Name:
Last Name:CHANDRASEKHAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5104 BRAEBURN DR
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4902
Mailing Address - Country:US
Mailing Address - Phone:713-882-4401
Mailing Address - Fax:
Practice Address - Street 1:5656 KELLEY ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77026-1967
Practice Address - Country:US
Practice Address - Phone:713-566-5440
Practice Address - Fax:713-566-4135
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG42722085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX146413304OtherCSHCN
TX8B8775OtherBCBS
TX146413301Medicaid
TX146413302OtherCSHCN
TX8B8775OtherBCBS
TX300125311Medicare PIN
TX146413301Medicaid