Provider Demographics
NPI:1114117769
Name:JHAVERI, CHIRAG DILIP (MD)
Entity Type:Individual
Prefix:
First Name:CHIRAG
Middle Name:DILIP
Last Name:JHAVERI
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 1:3705 MEDICAL PKWY STE 460
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1024
Mailing Address - Country:US
Mailing Address - Phone:512-454-5851
Mailing Address - Fax:512-454-5853
Practice Address - Street 1:3705 MEDICAL PKWY STE 460
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1024
Practice Address - Country:US
Practice Address - Phone:512-454-5851
Practice Address - Fax:512-454-5853
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036125974207W00000X
TXP3901207W00000X
LAMD.201807207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1005886Medicaid