Provider Demographics
NPI:1245403336
Name:NTAIMO, CHLOE AGNES (MD)
Entity Type:Individual
Prefix:
First Name:CHLOE
Middle Name:AGNES
Last Name:NTAIMO
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 1:2007 RAVENSTONE LOOP
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-4871
Mailing Address - Country:US
Mailing Address - Phone:979-690-9434
Mailing Address - Fax:
Practice Address - Street 1:2007 RAVENSTONE LOOP
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-4871
Practice Address - Country:US
Practice Address - Phone:979-690-9434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI57295207L00000X
TXM8879207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology