Provider Demographics
NPI:1225002918
Name:CHHABRA, ANIL (MD)
Entity Type:Individual
Prefix:
First Name:ANIL
Middle Name:
Last Name:CHHABRA
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 1:1811 E BERT KOUN LOOP
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-5740
Mailing Address - Country:US
Mailing Address - Phone:318-212-3858
Mailing Address - Fax:318-212-3958
Practice Address - Street 1:1811 E BERT KOUN LOOP
Practice Address - Street 2:SUITE 210
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5740
Practice Address - Country:US
Practice Address - Phone:318-212-3858
Practice Address - Fax:318-212-3958
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA06022R207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1331511Medicaid
B62157Medicare UPIN
LA50055Medicare ID - Type Unspecified