Provider Demographics
NPI:1578751939
Name:BALBIR S CHAHAL MD PA
Entity Type:Organization
Organization Name:BALBIR S CHAHAL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BALBIR
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:CHAHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-357-0661
Mailing Address - Street 1:455 SCHOOL ST
Mailing Address - Street 2:SUITE 44
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-4593
Mailing Address - Country:US
Mailing Address - Phone:281-357-0661
Mailing Address - Fax:832-516-6655
Practice Address - Street 1:455 SCHOOL ST
Practice Address - Street 2:SUITE 44
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-4593
Practice Address - Country:US
Practice Address - Phone:281-357-0661
Practice Address - Fax:832-516-6655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4389207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092458104Medicaid
TX092458104Medicaid