Provider Demographics
NPI:1427224112
Name:JO CHOUDHRY MDPA
Entity Type:Organization
Organization Name:JO CHOUDHRY MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JO
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOUDHRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-341-8001
Mailing Address - Street 1:16040 PARK VALLEY DR
Mailing Address - Street 2:SUITE 222
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-3578
Mailing Address - Country:US
Mailing Address - Phone:512-341-8001
Mailing Address - Fax:512-341-8011
Practice Address - Street 1:16040 PARK VALLEY DR
Practice Address - Street 2:SUITE 222
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-3578
Practice Address - Country:US
Practice Address - Phone:512-341-8001
Practice Address - Fax:512-341-8011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-02
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Z737Medicare PIN