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NPI Code Detail

MEDICARE: ALYSSA CHELLARAJ

MEDICARE: ALYSSA CHELLARAJ
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
1171000000XMilitary Health Care Provider

General Provider Information

NPI Number : 1417895079
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA CHELLARAJ
Provider Business Mailing Address
First Line : 3551 ROGER BROOKE DR
Second Line :
City : JBSA FT SAM HOUSTON
State : TX
Zip : 78234-4504
Country : US
Telephone Number : 210-916-0439
Fax Number : 210-916-6658
Provider Business Practice Location Address
First Line : 3551 ROGER BROOKE DR
Second Line :
City : JBSA FT SAM HOUSTON
State : TX
Zip : 78234-4504
Country : US
Telephone Number : 210-916-0439
Fax Number : 210-916-6658
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2026
Last Update Date : 03/31/2026

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Directions to “ ALYSSA CHELLARAJ ” Practice Location

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