MEDICARE: PALLAVI CHANDRA

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	103K00000X	Behavior Analyst	1653	TX
2	225XP0200X	Pediatric Occupational Therapist	117047	TX

General Provider Information

NPI Number	:	1184009896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PALLAVI CHANDRA

Provider Business Mailing Address
First Line	:	321 BRIDGEFORD DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78745-6677
Country	:	US
Telephone Number	:	513-310-1344
Fax Number	:

Provider Business Practice Location Address
First Line	:	3111 SACBE CV
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78745-7520
Country	:	US
Telephone Number	:	513-310-1344
Fax Number	:	737-277-5585

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

Provider Enumeration Date	:	07/23/2015
Last Update Date	:	11/07/2025

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Directions to “ PALLAVI CHANDRA ” Practice Location

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