Provider Demographics
NPI:1568529519
Name:CHOUDHRY, ZOHRA ANITA (MD)
Entity Type:Individual
Prefix:
First Name:ZOHRA
Middle Name:ANITA
Last Name:CHOUDHRY
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 1:1800 W. BOWIE ST.
Mailing Address - Street 2:#100-C
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76110
Mailing Address - Country:US
Mailing Address - Phone:682-233-7243
Mailing Address - Fax:817-921-0677
Practice Address - Street 1:1800 W. BOWIE ST
Practice Address - Street 2:#100-C
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76110
Practice Address - Country:US
Practice Address - Phone:682-233-7243
Practice Address - Fax:817-921-0677
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ19282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00281D2Medicaid
TX00281DMedicare ID - Type Unspecified
TXP00281D2Medicaid