Provider Demographics
NPI:1144200403
Name:CHITRIT, ISAAC (MD)
Entity Type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:
Last Name:CHITRIT
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 1:4715 S LAMAR BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SUNSET VALLEY
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1308
Mailing Address - Country:US
Mailing Address - Phone:512-442-1996
Mailing Address - Fax:512-441-1093
Practice Address - Street 1:4715 S LAMAR BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SUNSET VALLEY
Practice Address - State:TX
Practice Address - Zip Code:78745-1308
Practice Address - Country:US
Practice Address - Phone:512-442-1996
Practice Address - Fax:512-441-1093
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6906207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX127645306Medicaid
TX316248YLPSOtherWELLMED PTAN
TX127645308Medicaid
TX127645308Medicaid
TX8452N0Medicare PIN