Provider Demographics
NPI:1447288022
Name:KUNAVARAPU, CHANDRASEKHAR R (MD)
Entity type:Individual
Prefix:DR
First Name:CHANDRASEKHAR
Middle Name:R
Last Name:KUNAVARAPU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8201 EWING HALSELL
Mailing Address - Street 2:MEZZANINE FLOOR
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3707
Mailing Address - Country:US
Mailing Address - Phone:210-575-8485
Mailing Address - Fax:
Practice Address - Street 1:4499 MEDICAL DRIVE
Practice Address - Street 2:SUITE 166
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3771
Practice Address - Country:US
Practice Address - Phone:210-575-8485
Practice Address - Fax:210-575-8647
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1717207RC0000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00692822OtherR.ROAD
TX201688301Medicaid
TX201688302OtherCSN
8BX659OtherBCBS TX
TX201688302OtherCSN