MEDICARE: CHALKIAS CARDIOLOGY PLLC

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	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1205433455
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHALKIAS CARDIOLOGY PLLC

Provider Business Mailing Address
First Line	:	11671 JOLLYVILLE RD STE 120
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-4141
Country	:	US
Telephone Number	:	512-675-6098
Fax Number	:

Provider Business Practice Location Address
First Line	:	11671 JOLLYVILLE RD STE 120
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-4141
Country	:	US
Telephone Number	:	512-675-6098
Fax Number	:

Authorized Official
Title or Position	:	MD/OWNER
Name	:	FOTINI CHALKIAS
Credential	:
Telephone Number	:	512-675-6142

Provider Enumeration Date	:	10/01/2020
Last Update Date	:	10/01/2020

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