Provider Demographics
NPI:1215592381
Name:CHAUDHARY, CHHAVI (MD)
Entity Type:Individual
Prefix:
First Name:CHHAVI
Middle Name:
Last Name:CHAUDHARY
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 1:11937 US HWY 271
Mailing Address - Street 2:ATTN: KATE WELLS
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75708
Mailing Address - Country:US
Mailing Address - Phone:903-877-7777
Mailing Address - Fax:
Practice Address - Street 1:11937 US HWY 271
Practice Address - Street 2:ATTN: KATE WELLS
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75708
Practice Address - Country:US
Practice Address - Phone:903-877-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-04
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP1006319390200000X
MI43015110672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program