1578751939 NPI number — BALBIR S CHAHAL MD PA

Table of content: (NPI 1578751939)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578751939 NPI number — BALBIR S CHAHAL MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BALBIR S CHAHAL MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578751939
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/07/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
455 SCHOOL ST
Provider Second Line Business Mailing Address:
SUITE 44
Provider Business Mailing Address City Name:
TOMBALL
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77375-4593
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-357-0661
Provider Business Mailing Address Fax Number:
832-516-6655

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
455 SCHOOL ST
Provider Second Line Business Practice Location Address:
SUITE 44
Provider Business Practice Location Address City Name:
TOMBALL
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77375-4593
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-357-0661
Provider Business Practice Location Address Fax Number:
832-516-6655
Provider Enumeration Date:
10/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CHAHAL
Authorized Official First Name:
BALBIR
Authorized Official Middle Name:
SINGH
Authorized Official Title or Position:
CEO/ PRESIDENT
Authorized Official Telephone Number:
281-357-0661

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  K4389 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 092458104 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com