Provider Demographics
NPI:1679740310
Name:CHILAKAPATI, VENKATA SAMBA SIVA RAO (MD)
Entity Type:Individual
Prefix:DR
First Name:VENKATA
Middle Name:SAMBA SIVA RAO
Last Name:CHILAKAPATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:VENKATA
Other - Middle Name:S
Other - Last Name:CHILAKAPATI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:3400 COIT RD # 262609
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-3771
Mailing Address - Country:US
Mailing Address - Phone:469-782-9860
Mailing Address - Fax:469-461-3581
Practice Address - Street 1:4100 W 15TH ST STE 110
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5826
Practice Address - Country:US
Practice Address - Phone:469-782-9860
Practice Address - Fax:469-461-3581
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101253145207RI0011X, 207RC0000X
TXQ4377207RC0000X, 207RI0011X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine