DR. CHARUKESI CHANDRASEKARAN (NPI# 1508173170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508173170 |
| Entity Type | Individual |
| Full Name | DR. CHARUKESI CHANDRASEKARAN |
| Credential | MD |
| Practice Address |
4450 Highland Ave Beaumont TX 77705-5205 |
| Mailing Address |
Po Box 66308 Houston TX 77266-6308 |
| Practice Telephone | 7133517360 |
| Mailing Telephone | 8325485000 |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2015-09-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Q2263 | TX | Allopathic & Osteopathic Physicians |
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Q2263 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | LEGACY SITE SPECIFIC MEDICARE # | 7471809 | 01 |
| TX | LEGACY COMMUNITY HEALTH SERVICES INC MEDICIAID | 080462703 | 01 |
| Street Address |
4450 HIGHLAND AVE |
| City | BEAUMONT |
| State | TX |
| Zip Code | 77705-5205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275536740 | Kimberlie J Gonzalez | Family Medicine | 4450 Highland Ave, Beaumont, TX 77705-5205 | 2005-05-27 |
| 1366812000 | Rachel Adams | Nurse Practitioner | 4450 Highland Ave, Beaumont, TX 77705-5205 | 2015-10-06 |
| 1447671987 | Rose Brooks Lorenzen | Counselor | 4450 Highland Ave, Beaumont, TX 77705-5205 | 2013-12-31 |
| 1235482878 | Legacy Community Health Services, Inc | Clinic/Center | 4450 Highland Ave, Beaumont, TX 77705-5205 | 2012-10-19 |
| 1598037608 | Cynthia Renee Roland | Obstetrics & Gynecology | 4450 Highland Ave, Beaumont, TX 77705 | 2012-02-04 |
| 1932483526 | Gaurav Puri Pa | Dentist | 4450 Highland Ave, Beaumont, TX 77705-5205 | 2011-10-01 |
| 1689801730 | Harry Jae Doyle | Nurse Practitioner | 4450 Highland Ave, Beaumont, TX 77705-5205 | 2009-06-16 |
| 1093957417 | Rhonda S Dixon | Registered Nurse | 4450 Highland Ave, Beaumont, TX 77705-5205 | 2009-03-31 |
| 1225190416 | Lois E Muhammad | Family Medicine | 4450 Highland Ave, Beaumont, TX 77705 | 2006-12-14 |
| 1447361175 | Kimberly Lynn King | Nurse Practitioner | 4450 Highland Ave, Beaumont, TX 77705 | 2006-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801431390 | Iris Fiaui | Specialist/Technologist | 4400 Mlk Jr Pkwy, Beaumont, TX 77705 | 2019-11-08 |
| 1437644937 | Kolten Elizabeth Adams | Specialist/Technologist | 4400 S Mlk Jr Parkway, Beaumont, TX 77705 | 2018-06-27 |
| 1326443391 | Scott Forbes | Psychologist | 6200 Knauth Rd, Beaumont, TX 77705 | 2014-11-03 |
| 1518367622 | Dennis Agricola | Nurse Practitioner | 6200 Knauth Road, Beaumont, TX 77705 | 2014-08-26 |
| 1639591480 | Chs Texas Medical, P.a. | General Practice | 11357 Highway 10 Sw, Smith Rd, Beaumont, TX 77705 | 2014-01-14 |
| 1649523309 | Tri-medical Emergency Medical Services Lp | Ambulance | 4610 St. Louis St, Beaumont, TX 77705 | 2012-10-18 |
| 1437462785 | Cynthia Ksiazek | Social Worker | 857 E Virginia, Beaumont, TX 77705 | 2010-07-15 |
| 1457509424 | Gaurav Puri | Dentist | 4400 Highland Ave, Beaumont, TX 77705 | 2008-09-03 |
| 1588811731 | Prasad L Surapaneni | Family Medicine | 5430 Knauth Rd, Beaumont, TX 77705 | 2008-08-19 |
| 1891994612 | Jennifer Lien Truong | Occupational Therapist | 4205 Grandberry, Beaumont, TX 77705 | 2007-07-12 |
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| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225572555 | Jason Mensah Do Pa | Psychiatry & Neurology | 3560 Delaware St Ste 207, Beaumont, TX 77706-3059 | 2016-12-06 |
| 1205146511 | Rajen Desai Md Pa | Psychiatry & Neurology | 3560 Delaware Ste 905, Beaumont, TX 77706 | 2010-10-20 |
| 1902000565 | Lisa Michelle Doguet | Psychiatry & Neurology | 3250 Fannin St, Department of Psychiatry, Beaumont, TX 77701-3903 | 2007-06-14 |
| 1851429757 | Erica Jean Hayes | Psychiatry & Neurology | 4a Bayou Brandt, Beaumont, TX 77706-2612 | 2007-03-01 |
| 1679643191 | Ravikumar Kanneganti | Psychiatry & Neurology | 3250 Medical Center Dr, Beaumont, TX 77701-4627 | 2006-11-09 |
| 1306955398 | Mark Bradley Morman | Psychiatry & Neurology | 2750 S 8th St Bldg A, Beaumont, TX 77701-7719 | 2006-08-30 |
| 1851313985 | Sharad B Kulkarni | Psychiatry & Neurology | 2825 Interstate 10 E Ste 100, Beaumont, TX 77702-1015 | 2006-07-25 |
| 1730166075 | Kashi S Bagri | Psychiatry & Neurology | 2194a Eastex Fwy, Beaumont, TX 77703-4939 | 2005-12-28 |
| 1558342659 | Sriya De Silva | Psychiatry & Neurology | 85 Interstate 10 N Ste 201, Beaumont, TX 77707-2539 | 2005-11-07 |
| 1992701940 | Rajen B Desai | Psychiatry & Neurology | 3560 Delaware, Ste 905, Beaumont, TX 77706 | 2005-06-23 |
| Find all providers in BEAUMONT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.