Provider Demographics
NPI:1417650375
Name:CHOWDHURY, KRISHA (DO)
Entity Type:Individual
Prefix:
First Name:KRISHA
Middle Name:
Last Name:CHOWDHURY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7644 BRISTON PARK DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-4718
Mailing Address - Country:US
Mailing Address - Phone:210-396-9515
Mailing Address - Fax:
Practice Address - Street 1:19500 E ROSS ST
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-0515
Practice Address - Country:US
Practice Address - Phone:918-525-6191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program