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General NPI Number Information
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NPI Number | 1447286984
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Entity Type | Individual
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Provider Name | CHANDRAMOULI CHAKINALA M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 02/29/2012
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Provider Practice Location Address
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Address Line | 2200 9TH ST
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City | WICHITA FALLS
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State | TX
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Zip | 76301-4029
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Country | US
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Telephone | 940-723-4134
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Fax | 940-322-2341
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Provider Business Mailing Address
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Address Line | 3202 HAMILTON BLVD
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City | WICHITA FALLS
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State | TX
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Zip | 76308-2025
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Country | US
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Telephone | 940-322-9390
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Fax | 940-322-2341
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | F0413
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | F0413
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | F0413
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License Number State | TX
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