Provider Demographics
NPI:1750695672
Name:CHANDRASHEKAR, PARVATHAM (DDS)
Entity type:Individual
Prefix:DR
First Name:PARVATHAM
Middle Name:
Last Name:CHANDRASHEKAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7517 CAMERON RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-2057
Mailing Address - Country:US
Mailing Address - Phone:512-371-1222
Mailing Address - Fax:512-371-3914
Practice Address - Street 1:13729 RESEARCH BLVD
Practice Address - Street 2:SUITE 840
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1883
Practice Address - Country:US
Practice Address - Phone:512-258-7890
Practice Address - Fax:512-258-9014
Is Sole Proprietor?:No
Enumeration Date:2010-08-03
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX200021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice