Provider Demographics
NPI:1942882790
Name:CHAUHAN, PRIYANKA Y
Entity Type:Individual
Prefix:
First Name:PRIYANKA
Middle Name:Y
Last Name:CHAUHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PRIYANKABAHEN
Other - Middle Name:S
Other - Last Name:PARMAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3721 EXECUTIVE CENTER DR STE 201
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-1639
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9616 N LAMAR BLVD STE 105
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-4163
Practice Address - Country:US
Practice Address - Phone:512-527-9608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13444062251P0200X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics