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General NPI Number Information
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NPI Number | 1699945584
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Entity Type | Organization
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Legal Business Name | VIDYASAGAR CHODIMELLA, MD, FACC, P.A.
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Dates
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Enumeration Date | 03/06/2008
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Last Update Date | 09/13/2010
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Provider Practice Location Address
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Address Line | 4325 N JOSEY LN SUITE 204
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City | CARROLLTON
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State | TX
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Zip | 75010-4635
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Country | US
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Telephone | 972-395-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 4325 N JOSEY LN SUITE 204
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City | CARROLLTON
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State | TX
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Zip | 75010-4635
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Country | US
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Telephone | 972-395-7400
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. VIDYASAGAR CHODIMELLA
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Credential | MD
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Telephone | 972-395-7400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | L0088
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License Number State | TX
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