Provider Demographics
NPI:1336783620
Name:KEWALRAMANI, CHITRA
Entity Type:Individual
Prefix:DR
First Name:CHITRA
Middle Name:
Last Name:KEWALRAMANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 S SAINT MARYS ST UNIT 1507
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-2803
Mailing Address - Country:US
Mailing Address - Phone:857-284-3697
Mailing Address - Fax:
Practice Address - Street 1:2006 10TH ST
Practice Address - Street 2:
Practice Address - City:FLORESVILLE
Practice Address - State:TX
Practice Address - Zip Code:78114-2770
Practice Address - Country:US
Practice Address - Phone:830-393-8333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX357941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice