Provider Demographics
NPI:1881653186
Name:CHOWDHURY, RENUKA (MD)
Entity Type:Individual
Prefix:
First Name:RENUKA
Middle Name:
Last Name:CHOWDHURY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 LBJ FWY STE 700
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-6065
Mailing Address - Country:US
Mailing Address - Phone:214-358-2300
Mailing Address - Fax:145-796-9412
Practice Address - Street 1:1411 N BECKLEY AVE STE 370
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203-1513
Practice Address - Country:US
Practice Address - Phone:214-358-2300
Practice Address - Fax:214-579-6983
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4887207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXL4887OtherTX LICENSE