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NPI Code Detail

MEDICARE: DAVID CHANDROSS P.T.A

MEDICARE: DAVID CHANDROSS P.T.A
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
1171100000XAcupuncturistAC00608TX
2225200000XPhysical Therapy Assistant2034759TX

General Provider Information

NPI Number : 1558638148
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID CHANDROSS P.T.A
Provider Business Mailing Address
First Line : 1815 ENCLAVE PKWY
Second Line : # 6307
City : HOUSTON
State : TX
Zip : 77077-3671
Country : US
Telephone Number : 281-920-0591
Fax Number :
Provider Business Practice Location Address
First Line : 1815 ENCLAVE PKWY
Second Line : # 6307
City : HOUSTON
State : TX
Zip : 77077-3671
Country : US
Telephone Number : 281-920-0591
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2011
Last Update Date : 04/27/2013

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