Provider Demographics
NPI:1831544055
Name:CNS COLORECTAL SERVICES
Entity type:Organization
Organization Name:CNS COLORECTAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHITRA
Authorized Official - Middle Name:NEELA
Authorized Official - Last Name:SAMBASIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-445-9999
Mailing Address - Street 1:7580 FANNIN ST
Mailing Address - Street 2:STE 303
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1900
Mailing Address - Country:US
Mailing Address - Phone:832-942-8350
Mailing Address - Fax:
Practice Address - Street 1:7580 FANNIN ST
Practice Address - Street 2:STE 303
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1900
Practice Address - Country:US
Practice Address - Phone:832-942-8350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA73145208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty