Provider Demographics
NPI:1265658397
Name:CHOWDHURY, JULIA (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:
Last Name:CHOWDHURY
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 1:4100 W 15TH ST
Mailing Address - Street 2:SUITE #114
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5803
Mailing Address - Country:US
Mailing Address - Phone:972-985-0400
Mailing Address - Fax:972-985-0447
Practice Address - Street 1:4100 W 15TH ST
Practice Address - Street 2:SUITE #114
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5803
Practice Address - Country:US
Practice Address - Phone:972-985-0400
Practice Address - Fax:972-985-0447
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5164207VX0000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX384286ZLMMedicare PIN
OK200199640AMedicaid
MO1265658397Medicaid
KS200558440BMedicaid