Provider Demographics
NPI:1700196532
Name:R. CHANDRASEKARAN, MD, PA
Entity Type:Organization
Organization Name:R. CHANDRASEKARAN, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAMACHANDRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDRASEKHARAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-968-8523
Mailing Address - Street 1:1210 E 8TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-7111
Mailing Address - Country:US
Mailing Address - Phone:956-968-8523
Mailing Address - Fax:956-969-1761
Practice Address - Street 1:1210 E 8TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-7111
Practice Address - Country:US
Practice Address - Phone:956-968-8523
Practice Address - Fax:956-969-1761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE5497174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty