MEDICARE: RAVI CHANDRASEKHARA 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	207RC0000X	Cardiovascular Disease Physician	L0770	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	060062653	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	85551X	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1457395360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAVI CHANDRASEKHARA MD

Provider Business Mailing Address
First Line	:	8144 WALNUT HILL LN STE 450
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-0906
Country	:	US
Telephone Number	:	469-513-2666
Fax Number	:	469-513-2667

Provider Business Practice Location Address
First Line	:	3650 W WHEATLAND RD STE C
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75237-4409
Country	:	US
Telephone Number	:	469-513-2666
Fax Number	:	469-513-2667

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

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	03/04/2026

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Directions to “ RAVI CHANDRASEKHARA MD” Practice Location

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