MEDICARE: ARCHANA CHANDRA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	K8724	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	81Y187	OTHER	TX	BCBS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134198013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARCHANA CHANDRA MD

Provider Business Mailing Address
First Line	:	502 N VALLEY PKWY
Second Line	:	SUITE 1
City	:	LEWISVILLE
State	:	TX
Zip	:	75067-3437
Country	:	US
Telephone Number	:	972-353-8616
Fax Number	:	972-353-5352

Provider Business Practice Location Address
First Line	:	502 N VALLEY PKWY
Second Line	:	SUITE 1
City	:	LEWISVILLE
State	:	TX
Zip	:	75067-3437
Country	:	US
Telephone Number	:	972-353-8616
Fax Number	:	972-353-5352

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	04/30/2013

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