Provider Demographics
NPI:1437161841
Name:CHIMANJI MD PA
Entity Type:Organization
Organization Name:CHIMANJI MD PA
Other - Org Name:NR URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOWDER
Authorized Official - Suffix:
Authorized Official - Credentials:CPC, CCP
Authorized Official - Phone:940-384-6238
Mailing Address - Street 1:7920 PRESTON RD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2343
Mailing Address - Country:US
Mailing Address - Phone:469-362-8441
Mailing Address - Fax:469-362-8437
Practice Address - Street 1:7920 PRESTON RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2343
Practice Address - Country:US
Practice Address - Phone:469-362-8441
Practice Address - Fax:469-362-8437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TAX ID NUMBEROther