Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | Q7260 | TX |
NPI | 1043654718 |
---|---|
Provider Name | Dr. Chanthu Pillai |
First Address | Galveston, TX 77555 |
Second Address | Galveston, TX 77555-3000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2013 |
Last Update Date | 23/05/2020 |