Provider Demographics
NPI:1407845399
Name:CHALASANI, RAMBABU (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMBABU
Middle Name:
Last Name:CHALASANI
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 1:275 LANTERN BEND DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2840
Mailing Address - Country:US
Mailing Address - Phone:281-440-0101
Mailing Address - Fax:281-440-6441
Practice Address - Street 1:275 LANTERN BEND DR
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2840
Practice Address - Country:US
Practice Address - Phone:281-440-0101
Practice Address - Fax:281-440-6441
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP1060207RG0100X
FLME101734207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL281375100Medicaid
FLI26030Medicare UPIN
FL281375100Medicaid