Individual provider Active NPI

Nalina Chandrasekharan, MD

  • Pediatrics Physician
  • Tomball, TX
National Provider Identifier
1104967025
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
Q1802 Issued in TX
Practice address
11011 Northpointe Blvd Ste C
Tomball, TX 77375-1572
Phone
(281) 246-1100
NPI assigned
Feb 12, 2007
Last updated
Apr 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Q1802 TX Primary

Addresses

Primary practice location

11011 Northpointe Blvd Ste C
Tomball, TX 77375-1572

Mailing address

11011 Northpointe Blvd Ste C
Tomball, TX 77375-1572
Phone (281) 246-1100

Other practice location 1

4560 Fm 1960 Rd W
Ste 101
Houston, TX 77069-4627
Phone (281) 444-0000

Other identifiers 1

IdentifierTypeStateIssuer
3505406MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
Q1802TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Houston Internal Medicine and Pediatric Clinic PLLC Pediatrics CurrentSince Apr 20, 2021 Accepting new patients
Cypress Creek Pediatric Clinic Pediatrics Current Accepting new patients

Locations

11011 Northpointe Blvd
Ste C
Tomball, TX 77375
Phone (281) 246-1100

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1104967025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11011 NORTHPOINTE BLVD STE C",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773751572",
            "telephone_number": "281-246-1100",
            "fax_number": "281-430-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11011 NORTHPOINTE BLVD STE C",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773751572",
            "telephone_number": "281-246-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4560 Fm 1960 Rd W",
            "address_2": "STE 101",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770694627",
            "country_code": "US",
            "telephone_number": "281-444-0000",
            "fax_number": "281-444-6158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANDRASEKHARAN",
        "first_name": "NALINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q1802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3505406",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tomball, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.