Provider Demographics
NPI:1245274026
Name:WEERATUNGE, CHAMALEE NAMAL (MD)
Entity type:Individual
Prefix:
First Name:CHAMALEE
Middle Name:NAMAL
Last Name:WEERATUNGE
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:PO BOX 1090
Mailing Address - Street 2:CENTRAL TEXAS INFECTIOUS DISEASE, P.A.
Mailing Address - City:MANCHACA
Mailing Address - State:TX
Mailing Address - Zip Code:78652-1090
Mailing Address - Country:US
Mailing Address - Phone:210-771-9147
Mailing Address - Fax:210-771-9147
Practice Address - Street 1:598 N UNION AVE
Practice Address - Street 2:STE. 350
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130
Practice Address - Country:US
Practice Address - Phone:830-625-5103
Practice Address - Fax:512-828-7984
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3110207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX182468201Medicaid
TXP00356308OtherMEDICARE RAILROAD
TX0093NSOtherBCBS
TX612496Medicare PIN