Basic Information
Provider Information
NPI: 1982341962
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAUHAN
FirstName: ANUPSINH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 301 UNIVERSITY BLVD
Address2:  
City: GALVESTON
State: TX
PostalCode: 775551120
CountryCode: US
TelephoneNumber: 4097722166
FaxNumber: 4097722663
Practice Location
Address1: 301 UNIVERSITY BLVD
Address2:  
City: GALVESTON
State: TX
PostalCode: 775555302
CountryCode: US
TelephoneNumber: 4097722222
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/19/2022
LastUpdateDate: 06/22/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/22/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XBP10079490TXY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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