Provider Demographics
NPI:1649761487
Name:HARSHIDA J CHAUDHARI MD PA
Entity Type:Organization
Organization Name:HARSHIDA J CHAUDHARI MD PA
Other - Org Name:I AND MY DOCTORS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARSHIDABEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAUDHARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-303-5678
Mailing Address - Street 1:4107 WINESAP BEND DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-4637
Mailing Address - Country:US
Mailing Address - Phone:281-303-5678
Mailing Address - Fax:
Practice Address - Street 1:2225 WILLIAMS TRACE BLVD STE 109
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4440
Practice Address - Country:US
Practice Address - Phone:281-303-5678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR1006207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty