Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Mimi Chandrabose, PA-C

Individual provider Medical Physician Assistant · NPI 1336402700

MS. Mimi Chandrabose, PA-C is a Physician Assistant in Houston, Texas. Qualified in 2008, 18 years ago. Practices with Privia Medical Group Gulf Coast PLLC, a 538-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
18
Licensed in
TX
In the registry since
2012
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3003 S Loop W 210
Houston, TX 77054-1301
Phone: (713) 662-9500
Fax: (713) 662-9501
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA06143 (TX)

Record details

NPI number1336402700
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 20, 2012
Last updated in NPPESJune 20, 2012

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Privia Medical Group Gulf Coast Pllc — 538 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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