Individual
SRIVASA B CHEBROLU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4401 COIT RD, SUITE 303, FRISCO, TX 75035-0500
(469) 574-0464
(469) 574-0471
Mailing address
1600 WATERS RIDGE DR STE A, LEWISVILLE, TX 75057-6039
(940) 320-1708
(940) 565-5457
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
M1050
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
173507801
—
TX
01
—
P00239743
RR MEDICARE
—
Enumeration date
11/04/2005
Last updated
08/27/2024
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