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General NPI Number Information
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NPI Number | 1073026704
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Entity Type | Organization
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Legal Business Name | VALLEY RANCH INTERNAL MEDICINE, PLLC
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Dates
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Enumeration Date | 11/16/2017
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 9901 VALLEY RANCH PKWY E STE 2073
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City | IRVING
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State | TX
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Zip | 75063-7191
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Country | US
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Telephone | 972-505-3401
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Fax | 214-377-8833
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Provider Business Mailing Address
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Address Line | 9901 VALLEY RANCH PKWY E STE 2073
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City | IRVING
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State | TX
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Zip | 75063-7191
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Country | US
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Telephone | 972-505-3401
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Fax | 214-377-8833
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Authorized Official
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Title or Position | MD
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Name | VIJAYA SHREE CHINTALA
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Credential | MD
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Telephone | 972-505-3401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | M8598
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License Number State | TX
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