Individual
AJITHA CHANDRAMOHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1743 SOUTHVIEW CIR, CENTER, TX 75935-9324
(936) 591-8888
(936) 591-8884
Mailing address
1743 SOUTHVIEW CIR, CENTER, TX 75935-9324
(936) 591-8888
(936) 591-8884
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
K7000
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156997201
—
TX
Enumeration date
07/06/2005
Last updated
01/18/2012
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