Organization
ASHA KANCHARLA MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASHA KANCHARLA MD (OWNER/DOCTOR)
(903) 723-1940
Entity
Organization
Contact information
Practice address
300 WILLOW CREEK PKWY, PALESTINE, TX 75801-4421
(903) 723-1940
(903) 723-8307
Mailing address
300 WILLOW CREEK PKWY, 210 A, PALESTINE, TX 75801-4421
(903) 723-1940
(903) 723-9891
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
L4014
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00S2S2
BCBS
TX
01
—
DC0364
MEDICARE RR
TX
Enumeration date
05/26/2015
Last updated
10/15/2015
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