Healthcare Provider Details
I. General information
NPI: 1003307497
Provider Name (Legal Business Name): ANUSHA CHINTHAPARTHI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/22/2018
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9835 N LAKE CREEK PKWY
AUSTIN TX
78717-6210
US
IV. Provider business mailing address
9835 N LAKE CREEK PKWY
AUSTIN TX
78717-6210
US
V. Phone/Fax
- Phone: 832-826-1380
- Fax: 832-825-2799
- Phone: 832-826-1380
- Fax: 832-825-2799
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | BP10063709 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | MT222314 |
| License Number State | PA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080N0001X |
| Taxonomy | Neonatal-Perinatal Medicine Physician |
| License Number | V1054 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: