Individual
SAMATHA CHANDUPATLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1902 WINDSOR PL STE 102, FORT WORTH, TX 76110-1866
(682) 207-1700
(682) 250-5246
Mailing address
1902 WINDSOR PL STE 102, FORT WORTH, TX 76110-1866
(682) 207-1700
(682) 250-5246
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
M1045
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114918356
—
TX
05
—
174471605
—
TX
01
—
8U1252
BLUE CROSS
TX
Enumeration date
11/04/2005
Last updated
10/24/2025
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