Ricardo Chujutalli, CSA
Physician Assistant, Surgical in Grand Prairie, TX. Individual provider (NPI-1).
NPI number1215178769
StatusActive
Last updated in NPPESMar 26, 2015
Details
- NPI
- 1215178769
- Entity type
- Individual (NPI-1)
- Name
- Ricardo Chujutalli
- Credential
- CSA
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 12, 2009
- Last updated
- Mar 26, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | – | – | Yes |
| 246ZC0007X | Specialist/Technologist, Other, Surgical Assistant | – | – |
Practice location
4924 Marsh Harrier AveGrand Prairie, TX 75052-3057
Phone 972-652-0705 · Fax 972-752-7889
Mailing address
4924 Marsh Harrier AveGrand Prairie, TX 75052-3057
Phone 972-652-0705 · Fax 972-752-7889
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