Chandratara, Pa | |
4500 Hillcrest Rd Ste 115 Frisco TX 75035-5418 | |
(469) 213-6400 | |
(469) 213-6473 |
Full Name | Chandratara, Pa |
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Speciality | Psychologist - Prescribing (medical) |
Location | 4500 Hillcrest Rd Ste 115, Frisco, Texas |
Authorized Official Name and Position | Swati Ellendula (PSYCHIATRIST) |
Authorized Official Contact | 4692136400 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Chandratara, Pa 4500 Hillcrest Rd Ste 115 Frisco TX 75035-5418 Ph: (469) 213-6400 | Chandratara, Pa 4500 Hillcrest Rd Ste 115 Frisco TX 75035-5418 Ph: (469) 213-6400 |
NPI Number | 1245596006 |
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Provider Enumeration Date | 04/05/2012 |
Last Update Date | 04/15/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1245596006 | NPI | - | NPPES |
318504 | Other | TX | MEDICARE PTAN |
363043 | Other | TX | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TP0016X | Psychologist - Prescribing (medical) | N9542 (Texas) | Primary |
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