Provider Demographics
NPI:1679738355
Name:CHAUDHARY, DINESH (MD)
Entity Type:Individual
Prefix:DR
First Name:DINESH
Middle Name:
Last Name:CHAUDHARY
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 1:6400 HILLCROFT ST STE 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-3107
Mailing Address - Country:US
Mailing Address - Phone:713-988-3921
Mailing Address - Fax:713-771-8552
Practice Address - Street 1:6400 HILLCROFT ST STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-3107
Practice Address - Country:US
Practice Address - Phone:713-988-3921
Practice Address - Fax:713-771-8552
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301091545207R00000X
MN55039207R00000X, 208000000X
TXR6364207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1679738355Medicaid
MN110015646Medicare PIN