Provider Demographics
NPI:1518065317
Name:CHALKIAS, FOTINI MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:FOTINI
Middle Name:MARIA
Last Name:CHALKIAS
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:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:800-944-0371
Mailing Address - Fax:254-215-9722
Practice Address - Street 1:2608 BROCKTON DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-4414
Practice Address - Country:US
Practice Address - Phone:512-654-4050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5092207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX185786406Medicaid
TX185786407Medicaid
TX8CU861OtherBCBS
TX185786408Medicaid
TX8ET189OtherBCBS
TX185786405Medicaid
TXP01040680OtherRAILROAD MEDICARE
TX329746YMGJMedicare PIN
TX185786405Medicaid
H84103Medicare UPIN
TX329746YL9XMedicare PIN
TX185786407Medicaid