MEDICARE: SRI KRISHNA CHAITANYA PATCHALA 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	208100000X	Physical Medicine & Rehabilitation Physician	2019045761	MO
2	208100000X	Physical Medicine & Rehabilitation Physician	036-141524	IL
3	208100000X	Physical Medicine & Rehabilitation Physician	2012016755	MO

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619230794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SRI KRISHNA CHAITANYA PATCHALA M.D

Provider Business Mailing Address
First Line	:	1776 WOODSTEAD CT STE 208
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77380-1480
Country	:	US
Telephone Number	:	877-749-7428
Fax Number	:	512-628-3314

Provider Business Practice Location Address
First Line	:	1027 BELLEVUE AVE
Second Line	:
City	:	RICHMOND HEIGHTS
State	:	MO
Zip	:	63117-1996
Country	:	US
Telephone Number	:	314-768-5202
Fax Number	:

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

Provider Enumeration Date	:	06/22/2012
Last Update Date	:	12/02/2025

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Directions to “ SRI KRISHNA CHAITANYA PATCHALA M.D” Practice Location

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