Provider Demographics
NPI:1902991953
Name:NANGRANI, CHAITALI DWARKADAS (MD)
Entity Type:Individual
Prefix:
First Name:CHAITALI
Middle Name:DWARKADAS
Last Name:NANGRANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 MCBETH WAY STE 190
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-1352
Mailing Address - Country:US
Mailing Address - Phone:281-298-5476
Mailing Address - Fax:281-298-5241
Practice Address - Street 1:8000 MCBETH WAY STE 190
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-1352
Practice Address - Country:US
Practice Address - Phone:281-298-5476
Practice Address - Fax:281-298-5241
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN102694207P00000X
TXN7652207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN003130000Medicaid
MNP00348902OtherMEDICARE RAILROAD
MNP00348902OtherMEDICARE RAILROAD
930002596Medicare ID - Type Unspecified