Provider Demographics
NPI:1578585337
Name:CHITNIS, SHILPA (MD)
Entity Type:Individual
Prefix:
First Name:SHILPA
Middle Name:
Last Name:CHITNIS
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 1:700 OLYMPIC PLAZA CIR STE 904
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-1958
Mailing Address - Country:US
Mailing Address - Phone:903-535-6092
Mailing Address - Fax:
Practice Address - Street 1:700 OLYMPIC PLAZA CIR STE 904
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-1958
Practice Address - Country:US
Practice Address - Phone:903-535-6092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM65662084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology