MEDICARE: BUSHRA I CHAUDHRY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	L1816	TX

General Provider Information

NPI Number	:	1174502769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BUSHRA I CHAUDHRY MD

Provider Business Mailing Address
First Line	:	911 WYNDHAM WAY
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75013-5364
Country	:	US
Telephone Number	:	972-832-7040
Fax Number	:

Provider Business Practice Location Address
First Line	:	5495 BELT LINE RD STE 200
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75254-7658
Country	:	US
Telephone Number	:	954-939-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	11/29/2024

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