Individual
TARA CHILAKAMARRI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
919 E 32ND ST, AUSTIN, TX 78705-2703
(512) 544-5116
Mailing address
2101 MONTOPOLIS DR UNIT 20, AUSTIN, TX 78741-6509
(314) 755-8482
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
2013-02427
NC
208100000X
Physical Medicine & Rehabilitation Physician
2015032305
MO
208100000X
Physical Medicine & Rehabilitation Physician
51357
KY
208100000X
Physical Medicine & Rehabilitation Physician
58141
TN
208100000X
Physical Medicine & Rehabilitation Physician
Primary
R4818
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306165295
—
NC
05
—
300017310
—
IN
05
—
7100556760
—
KY
05
—
NC2127
—
SC
Enumeration date
05/18/2010
Last updated
04/04/2022
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