| Shital Chavda M.d., Pllc | |
|
4214 Gateway Dr Ste 100 Colleyville TX 76034-7906 | |
| (352) 514-2269 | |
| Not Available |
| Full Name | Shital Chavda M.d., Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 4214 Gateway Dr Ste 100, Colleyville, Texas |
| Authorized Official Name and Position | Shital Chavda (SOLE MEMBER) |
| Authorized Official Contact | 3525142269 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shital Chavda M.d., Pllc Po Box 630221 Irving TX 75063-0115 Ph: (352) 514-2269 | Shital Chavda M.d., Pllc 4214 Gateway Dr Ste 100 Colleyville TX 76034-7906 Ph: (352) 514-2269 |
| NPI Number | 1336968098 |
|---|---|
| Provider Enumeration Date | 10/08/2024 |
| Last Update Date | 11/03/2024 |
| Medicare PECOS PAC ID | 0446780951 |
|---|---|
| Medicare Enrollment ID | O20250213002217 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336968098 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Daniela Dillman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316371842 PECOS PAC ID: 5597993972 Enrollment ID: I20220811002350 |
| Provider Name | Shital P Chavda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306167085 PECOS PAC ID: 3678717675 Enrollment ID: I20230105000015 |
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