Individual
NANDINI CHANNABASAPPA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1935 MEDICAL DISTRICT DR, DALLAS, TX 75235-7701
(214) 456-8000
(214) 456-8006
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(214) 456-8000
(214) 456-8006
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
M7903
TX
2080P0206X
Pediatric Gastroenterology Physician
Primary
M7903
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8AL505
BCBS
TX
Enumeration date
05/04/2007
Last updated
04/06/2012
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