Provider Demographics
NPI:1487674511
Name:CHANDLER, KRISTIE RICHARDSON (MD)
Entity Type:Individual
Prefix:
First Name:KRISTIE
Middle Name:RICHARDSON
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1595 LAKE FRONT CIR
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3604
Mailing Address - Country:US
Mailing Address - Phone:281-292-8980
Mailing Address - Fax:281-292-8070
Practice Address - Street 1:1595 LAKE FRONT CIR
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380
Practice Address - Country:US
Practice Address - Phone:281-292-8980
Practice Address - Fax:281-292-8070
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5147208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG04985Medicare UPIN