Provider Demographics
NPI:1457107633
Name:HEWAGE, CHANDANA N/A (MD RDMS RVT)
Entity Type:Individual
Prefix:DR
First Name:CHANDANA
Middle Name:N/A
Last Name:HEWAGE
Suffix:
Gender:M
Credentials:MD RDMS RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2452 HAMMOCK LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-6008
Mailing Address - Country:US
Mailing Address - Phone:940-273-0643
Mailing Address - Fax:
Practice Address - Street 1:2452 HAMMOCK LAKE DR
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-6008
Practice Address - Country:US
Practice Address - Phone:940-273-0643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-27
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography