Provider Demographics
NPI:1548339526
Name:CHINTALA, VIJAYA SHREE (MD)
Entity type:Individual
Prefix:
First Name:VIJAYA SHREE
Middle Name:
Last Name:CHINTALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13 WINDING HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-6435
Mailing Address - Country:US
Mailing Address - Phone:972-505-3401
Mailing Address - Fax:214-377-8833
Practice Address - Street 1:9901 VALLEY RANCH PKWY E STE 2073
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-7191
Practice Address - Country:US
Practice Address - Phone:972-505-3401
Practice Address - Fax:214-377-8833
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV22038207R00000X
TXM8598207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX195129501Medicaid
TX195129502Medicaid
TX8K8752Medicare PIN
TX8K8753Medicare PIN
WV145413Medicare UPIN