Provider Demographics
NPI:1770856288
Name:CHAP, KEVIN SAROO (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:SAROO
Last Name:CHAP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KEVIN
Other - Middle Name:SHAHROOZ
Other - Last Name:FATTAHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6720 BERTNER AVE., SUITE O-520, MS 1-226
Mailing Address - Street 2:ATTN: MARIE SANCHEZ
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:832-355-2666
Mailing Address - Fax:
Practice Address - Street 1:7200 CAMBRIDGE STREET
Practice Address - Street 2:10TH FLOOR
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4202
Practice Address - Country:US
Practice Address - Phone:713-798-1750
Practice Address - Fax:713-798-4693
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP1735207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX297765YK6UMedicare PIN