MEDICARE: PRIMARY CARE DOCTORS OF NORTH TEXAS PLLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1760147490
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMARY CARE DOCTORS OF NORTH TEXAS PLLC

Provider Business Mailing Address
First Line	:	4927 LAKE RIDGE PKWY STE 148
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-3000
Country	:	US
Telephone Number	:	972-217-4203
Fax Number	:	833-784-1531

Provider Business Practice Location Address
First Line	:	4927 LAKE RIDGE PKWY STE 148
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-3000
Country	:	US
Telephone Number	:	972-217-4203
Fax Number	:	833-784-1531

Authorized Official
Title or Position	:	MANAGER
Name	:	CHAITANYA CHAVDA
Credential	:	MD
Telephone Number	:	313-505-2932

Provider Enumeration Date	:	11/08/2021
Last Update Date	:	12/16/2025

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