Provider Demographics
NPI:1629087531
Name:CHAUDHRY, KAMRAN RIAZ (MD)
Entity Type:Individual
Prefix:
First Name:KAMRAN
Middle Name:RIAZ
Last Name:CHAUDHRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6100 CORSICA WAY
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024
Mailing Address - Country:US
Mailing Address - Phone:940-284-3884
Mailing Address - Fax:
Practice Address - Street 1:3000 N I-35
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-5119
Practice Address - Country:US
Practice Address - Phone:940-284-3884
Practice Address - Fax:877-442-9313
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALL-2456207R00000X
TXM7909207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8W9004OtherBCBS
TX200582902Medicaid
TXP00931079OtherMEDICARE RR THPG
TX8CQ508OtherBCBS THPG
TX8CQ508OtherBCBS THPG
TXP00931079OtherMEDICARE RR THPG