Basic Information
| Provider Information | |||||||||
| NPI: | 1093797193 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHEKURI | ||||||||
| FirstName: | KASI | ||||||||
| MiddleName: | VISWANATHA RAJU | ||||||||
| NamePrefix: | |||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1202 3RD ST | ||||||||
| Address2: | |||||||||
| City: | CORPUS CHRISTI | ||||||||
| State: | TX | ||||||||
| PostalCode: | 784042314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3618833962 | ||||||||
| FaxNumber: | 3618835398 | ||||||||
| Practice Location | |||||||||
| Address1: | 1202 3RD ST | ||||||||
| Address2: | |||||||||
| City: | CORPUS CHRISTI | ||||||||
| State: | TX | ||||||||
| PostalCode: | 784042314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3618833962 | ||||||||
| FaxNumber: | 3618835398 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2005 | ||||||||
| LastUpdateDate: | 01/27/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | M0375 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 0-601-314-8 | 01 | ECFMG | OTHER |