MEDICARE: DR. RAVINDRA CHANDRASHEKHAR M.D.

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	207R00000X	Internal Medicine Physician	Q7024	TX
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	A100759	CA
3	207RS0012X	Sleep Medicine (Internal Medicine) Physician	Q7024	TX

General Provider Information

NPI Number	:	1245422955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAVINDRA CHANDRASHEKHAR M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1292
Second Line	:
City	:	COPPELL
State	:	TX
Zip	:	75019-1207
Country	:	US
Telephone Number	:	469-501-2224
Fax Number	:	877-409-1532

Provider Business Practice Location Address
First Line	:	2008 E HEBRON PKWY STE 100
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75007-1601
Country	:	US
Telephone Number	:	469-501-2224
Fax Number	:	877-409-1532

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

Provider Enumeration Date	:	08/16/2007
Last Update Date	:	06/24/2024

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