Provider Demographics
NPI:1255190260
Name:LAMICHHANE, CHANDRA P
Entity type:Individual
Prefix:
First Name:CHANDRA
Middle Name:P
Last Name:LAMICHHANE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 BIG TIMBER DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-5295
Mailing Address - Country:US
Mailing Address - Phone:254-541-3205
Mailing Address - Fax:
Practice Address - Street 1:412 BIG TIMBER DR
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-5295
Practice Address - Country:US
Practice Address - Phone:254-541-3205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1388813225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty