Provider Demographics
NPI:1669696191
Name:CHOWDHURY, NUR S (MD)
Entity type:Individual
Prefix:DR
First Name:NUR
Middle Name:S
Last Name:CHOWDHURY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHAHAN
Other - Middle Name:
Other - Last Name:CHOWDHURY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4060 LEGACY DR STE 302
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6625
Mailing Address - Country:US
Mailing Address - Phone:214-945-3621
Mailing Address - Fax:888-511-6306
Practice Address - Street 1:4060 LEGACY DR STE 302
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6625
Practice Address - Country:US
Practice Address - Phone:214-945-3621
Practice Address - Fax:888-511-6306
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6322207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine