Provider Demographics
NPI:1205852779
Name:ASSANASEN, CHATCHAWIN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHATCHAWIN
Middle Name:
Last Name:ASSANASEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7703 FLOYD CURL DR
Mailing Address - Street 2:MC7977
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-450-9000
Mailing Address - Fax:210-450-4903
Practice Address - Street 1:333 N SANTA ROSA ST
Practice Address - Street 2:8TH FLOOR
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3108
Practice Address - Country:US
Practice Address - Phone:210-704-2187
Practice Address - Fax:210-704-3566
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME800842080P0207X
TXN91672080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX220350701Medicaid
TX220350702OtherCSHCN
TX220350702OtherCSHCN