Basic Information
| Provider Information | |||||||||
| NPI: | 1689627846 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHAVDA | ||||||||
| FirstName: | SURESH | ||||||||
| MiddleName: | N. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6015 JERICHO CT | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752482139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9727334186 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1625 MEDICAL CENTER DR | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799025005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9157474000 | ||||||||
| FaxNumber: | 2147122444 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | J2537 | TX | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.