1821364167 NPI number — DR. RIPA CHAKRAVORTY MD

Table of content: DR. RIPA CHAKRAVORTY MD (NPI 1821364167)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821364167 NPI number — DR. RIPA CHAKRAVORTY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAKRAVORTY
Provider First Name:
RIPA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1821364167
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/25/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6210 E HIGHWAY 290 STE 240
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78723-1144
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-483-9596
Provider Business Mailing Address Fax Number:
512-406-6216

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
708 W BEN WHITE BLVD
Provider Second Line Business Practice Location Address:
SUITE 220
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
737-272-0600
Provider Business Practice Location Address Fax Number:
512-406-7312
Provider Enumeration Date:
03/30/2012

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: 207R00000X , with the licence number:  R6360 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: R6360 , 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: 385689001 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 385689002 . This is a "CSHCN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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