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General NPI Number Information
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NPI Number | 1235293952
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Entity Type | Individual
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Provider Name | SRIDEVI CHAGANTI
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Gender | Female
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7575 FRANKFORD RD # 326
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City | DALLAS
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State | TX
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Zip | 75252-6459
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Country | US
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Telephone | 972-398-9638
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Fax |
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Provider Business Mailing Address
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Address Line | 7575 FRANKFORD RD 326
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City | DALLAS
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State | TX
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Zip | 75252-6459
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Country | US
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Telephone | 972-398-9638
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 35.088492
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License Number State | OH
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