MEDICARE: INDERJIT CHAWLA CCC-SLP

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	235Z00000X	Speech-Language Pathologist	112067	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	112067	OTHER	TX	TEXAS DEPARTMENT OF LICENSING AND REGULATION

General Provider Information

NPI Number	:	1548681265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INDERJIT CHAWLA CCC-SLP

Provider Business Mailing Address
First Line	:	10411 DEWEY EVE CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-5583
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2930 CYPRESS GROVE MEADOW DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77014
Country	:	US
Telephone Number	:	281-315-1450
Fax Number	:

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

Provider Enumeration Date	:	12/23/2013
Last Update Date	:	08/23/2018

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Directions to “ INDERJIT CHAWLA CCC-SLP” Practice Location

Language	Start Address	Practice Location

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