Healthcare Provider Details

I. General information

NPI: 1942799705
Provider Name (Legal Business Name): SIDDHARTH CHAUHAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2018
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17520 W GRAND PKWY S STE 280
SUGAR LAND TX
77479-4758
US

IV. Provider business mailing address

17520 W GRAND PKWY S STE 280
SUGAR LAND TX
77479-4758
US

V. Phone/Fax

Practice location:
  • Phone: 713-486-2400
  • Fax: 713-984-8539
Mailing address:
  • Phone: 713-486-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberW6195
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: