MEDICARE: AANCHAL CHANDRA D.D.S.

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	122300000X	Dentist	29012	TX

General Provider Information

NPI Number	:	1912346685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AANCHAL CHANDRA D.D.S.

Provider Business Mailing Address
First Line	:	6310 GOODLOWE PARK
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-5637
Country	:	US
Telephone Number	:	281-630-4333
Fax Number	:

Provider Business Practice Location Address
First Line	:	3201 BROADWAY ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77017-2320
Country	:	US
Telephone Number	:	713-643-2500
Fax Number	:	713-643-2797

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

Provider Enumeration Date	:	06/17/2013
Last Update Date	:	06/17/2013

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