Healthcare Provider Details

I. General information

NPI: 1407464068
Provider Name (Legal Business Name): KARTHIK CHAMARTI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2020
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2108 TEXAS AVE STE 3061
ALEXANDRIA LA
71301-3903
US

IV. Provider business mailing address

701 W 5TH ST STE 1229
ODESSA TX
79763-4206
US

V. Phone/Fax

Practice location:
  • Phone: 318-442-2232
  • Fax:
Mailing address:
  • Phone: 432-703-5375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number354562
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: