MEDICARE: CHANDRA S KATRAGADDA 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	2085R0202X	Diagnostic Radiology Physician	E5549	TX
2	2085R0204X	Vascular & Interventional Radiology Physician	E5549	TX

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

General Provider Information

NPI Number	:	1699764506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANDRA S KATRAGADDA MD

Provider Business Mailing Address
First Line	:	800 PEAKWOOD DR STE 5E
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-2903
Country	:	US
Telephone Number	:	281-440-5158
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 PEAKWOOD DR STE 5E
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-2903
Country	:	US
Telephone Number	:	281-440-5158
Fax Number	:

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

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	12/07/2023

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