Provider Demographics
NPI:1275836439
Name:CHOKKALINGAM, SITA (MS, LAC)
Entity Type:Individual
Prefix:
First Name:SITA
Middle Name:
Last Name:CHOKKALINGAM
Suffix:
Gender:F
Credentials:MS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4552 PAGE ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-5476
Mailing Address - Country:US
Mailing Address - Phone:512-596-5510
Mailing Address - Fax:
Practice Address - Street 1:4552 PAGE ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-5476
Practice Address - Country:US
Practice Address - Phone:512-596-5510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-09
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01410171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist