Provider Demographics
NPI:1144554866
Name:SUPARNA CHHIBBER MD PA
Entity type:Organization
Organization Name:SUPARNA CHHIBBER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SUPARNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHHIBBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-493-3681
Mailing Address - Street 1:909 DAIRY ASHFORD ST
Mailing Address - Street 2:SUITE 216
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-5309
Mailing Address - Country:US
Mailing Address - Phone:281-493-3681
Mailing Address - Fax:713-456-2549
Practice Address - Street 1:909 DAIRY ASHFORD ST
Practice Address - Street 2:SUITE 216
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-5309
Practice Address - Country:US
Practice Address - Phone:281-493-3681
Practice Address - Fax:713-456-2549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-28
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0367207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI25204Medicare UPIN