Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | K6546 | TX |
NPI | 1013928688 |
---|---|
Provider Name | Harish Chandna |
First Address | Victoria, TX 77901 |
Second Address | Victoria, TX 77901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 09/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
154290402 | (05) | TX |
8DD944 | BLUE CROSS BLUE SHIELDS (01) | TX |
G19797 | (02) |