Healthcare Provider Details

I. General information

NPI: 1902269020
Provider Name (Legal Business Name): DIVYA KIRAN CHHABRA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2016
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 ALPHA DR STE E-108
HIGHLAND HEIGHTS OH
44143-2139
US

IV. Provider business mailing address

16514 GLORIETTA TURN
HOUSTON TX
77068-1452
US

V. Phone/Fax

Practice location:
  • Phone: 305-902-6347
  • Fax:
Mailing address:
  • Phone: 281-687-9735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number151615
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: