MEDICARE: SUBHA CHIKKALA M.D.

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	207Q00000X	Family Medicine Physician	P5163	TX

General Provider Information

NPI Number	:	1245505254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUBHA CHIKKALA M.D.

Provider Business Mailing Address
First Line	:	2006 S BAGDAD RD STE 190
Second Line	:
City	:	LEANDER
State	:	TX
Zip	:	78641-3579
Country	:	US
Telephone Number	:	512-986-7372
Fax Number	:	512-986-7392

Provider Business Practice Location Address
First Line	:	2006 S BAGDAD RD STE 190
Second Line	:
City	:	LEANDER
State	:	TX
Zip	:	78641-3579
Country	:	US
Telephone Number	:	512-986-7372
Fax Number	:	512-986-7392

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

Provider Enumeration Date	:	03/09/2012
Last Update Date	:	01/20/2026

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