Provider Demographics
NPI:1679525281
Name:PERSAUD, CHANDROWTIE (CNM)
Entity type:Individual
Prefix:
First Name:CHANDROWTIE
Middle Name:
Last Name:PERSAUD
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13111 EAST FWY STE 215
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015-5803
Mailing Address - Country:US
Mailing Address - Phone:713-393-2229
Mailing Address - Fax:713-393-2281
Practice Address - Street 1:13111 EAST FWY STE 215
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-5803
Practice Address - Country:US
Practice Address - Phone:713-393-2229
Practice Address - Fax:713-393-2281
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX565945367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS22845Medicare UPIN