Provider Demographics
NPI:1508244914
Name:CHANDRASEKERA, LALANICA (DO)
Entity Type:Individual
Prefix:
First Name:LALANICA
Middle Name:
Last Name:CHANDRASEKERA
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 1:1315 ST JOSEPH PKWY STE 1818
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8238
Mailing Address - Country:US
Mailing Address - Phone:713-481-7048
Mailing Address - Fax:
Practice Address - Street 1:1315 ST JOSEPH PKWY STE 1818
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8238
Practice Address - Country:US
Practice Address - Phone:713-481-7048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-18
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10053943390200000X
TXS0857207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program