1770856288 NPI number — KEVIN SAROO CHAP M.D.

Table of content: KEVIN SAROO CHAP M.D. (NPI 1770856288)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770856288 NPI number — KEVIN SAROO CHAP M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAP
Provider First Name:
KEVIN
Provider Middle Name:
SAROO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FATTAHI
Provider Other First Name:
KEVIN
Provider Other Middle Name:
SHAHROOZ
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1770856288
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/24/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6720 BERTNER AVE., SUITE O-520, MS 1-226
Provider Second Line Business Mailing Address:
ATTN: MARIE SANCHEZ
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77030
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-355-2666
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7200 CAMBRIDGE STREET
Provider Second Line Business Practice Location Address:
10TH FLOOR
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030-4202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-798-1750
Provider Business Practice Location Address Fax Number:
713-798-4693
Provider Enumeration Date:
02/14/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  P1735 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207L00000X , with the licence number: 3947-320 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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