Healthcare Provider Details

I. General information

NPI: 1245215516
Provider Name (Legal Business Name): MANISH SAGARMAL CHAUHAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2005
Last Update Date: 01/04/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 PARK BEND DR BLDG. 2 SUITE 300
AUSTIN TX
78758-5387
US

IV. Provider business mailing address

2410 ROUND ROCK AVE STE 170
ROUND ROCK TX
78681-4002
US

V. Phone/Fax

Practice location:
  • Phone: 512-617-6000
  • Fax: 512-339-7838
Mailing address:
  • Phone: 512-827-0927
  • Fax: 512-827-0928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberM0039
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: