Provider Demographics
NPI:1811382310
Name:CHAKRABARTI, PRIYANKA (DO)
Entity Type:Individual
Prefix:
First Name:PRIYANKA
Middle Name:
Last Name:CHAKRABARTI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5115 WESTHEIMER RD STE C3550
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-5528
Mailing Address - Country:US
Mailing Address - Phone:833-334-6393
Mailing Address - Fax:
Practice Address - Street 1:5115 WESTHEIMER RD STE C3550
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-5528
Practice Address - Country:US
Practice Address - Phone:833-334-6393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-01
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR8539207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty