Basic Information
| Provider Information | |||||||||
| NPI: | 1326036450 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SETHI-DIHENIA | ||||||||
| FirstName: | CHANDA | ||||||||
| MiddleName: | S. | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5865 | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794085865 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067433150 | ||||||||
| FaxNumber: | 8067433168 | ||||||||
| Practice Location | |||||||||
| Address1: | 3601 4TH ST | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 79430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067433150 | ||||||||
| FaxNumber: | 8067433168 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2005 | ||||||||
| LastUpdateDate: | 01/11/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 01/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | K3157 | TX | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | K3157 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 87832Z | 01 | TX | HMO BLUE | OTHER | 124233106 | 05 | TX | MEDICAID | 37070 | 01 | NM | PRESBYTERIAN COMMERCIAL | OTHER | 100150107 | 01 | TX | FIRSTCARE COMMERCIAL | OTHER | 66744 | 05 | NM | MEDICAID | 8B2605 | 01 | TX | BC/BS | OTHER | A006 | 01 | TRIWEST | OTHER | 200042450A | 05 | OK | MEDICAID | 100150105 | 01 | TX | FIRSTCARE COMMERCIAL | OTHER | 100150106 | 05 | TX | MEDICAID |