Provider Demographics
NPI:1447365416
Name:IYER, CHANDRAMOULI PATTABIRAMAN
Entity type:Individual
Prefix:DR
First Name:CHANDRAMOULI
Middle Name:PATTABIRAMAN
Last Name:IYER
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:CHANDRAMOULI
Other - Middle Name:
Other - Last Name:PATTABIRMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, MS, MCH, FIPP
Mailing Address - Street 1:1220 WILLOWDALE LN
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-4476
Mailing Address - Country:US
Mailing Address - Phone:972-401-3090
Mailing Address - Fax:214-857-1867
Practice Address - Street 1:1220 WILLOWDALE LN
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-4476
Practice Address - Country:US
Practice Address - Phone:972-401-3090
Practice Address - Fax:214-857-1867
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35076055-I207L00000X
IN01046935207L00000X
TXM8730207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology