1437137981 NPI number — DR. MINAXI K RATHOD MD

Table of content: DR. MINAXI K RATHOD MD (NPI 1437137981)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437137981 NPI number — DR. MINAXI K RATHOD MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RATHOD
Provider First Name:
MINAXI
Provider Middle Name:
K
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RATHOD
Provider Other First Name:
MINAXI
Provider Other Middle Name:
K
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1437137981
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/12/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
321 N HIGHLAND AVE
Provider Second Line Business Mailing Address:
STE 100
Provider Business Mailing Address City Name:
SHERMAN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75092-7386
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-893-1011
Provider Business Mailing Address Fax Number:
866-240-2131

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
321 N HIGHLAND AVE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
SHERMAN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75092-7386
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-893-1011
Provider Business Practice Location Address Fax Number:
866-240-2131
Provider Enumeration Date:
01/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RI0200X , with the licence number:  G6377 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 5000182 . This is a "AETNA PIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 82A930 . This is a "BLUE SHIELD, TEXAS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 100048080A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 113236702 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 440002178 . This is a "RAILROAD MEDICARE PIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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