Provider Demographics
NPI:1861855215
Name:HALAHARVI, CHANDANA (DPM)
Entity Type:Individual
Prefix:
First Name:CHANDANA
Middle Name:
Last Name:HALAHARVI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 CULLEN BLVD STE 109
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3922
Mailing Address - Country:US
Mailing Address - Phone:281-406-1594
Mailing Address - Fax:
Practice Address - Street 1:2950 CULLEN BLVD STE 109
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-3922
Practice Address - Country:US
Practice Address - Phone:281-406-1594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-02
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3021213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3021OtherTEXAS MEDICAL LICENSE