1598143943 NPI number — AADITYA NAGARAJ

Table of content: AADITYA NAGARAJ (NPI 1598143943)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598143943 NPI number — AADITYA NAGARAJ

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NAGARAJ
Provider First Name:
AADITYA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598143943
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2255 BRAESWOOD PARK DR APT 259
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77030-4432
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-693-0633
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ONE BAYLOR PLAZA, BCM 620
Provider Second Line Business Practice Location Address:
BAYLOR COLLEGE OF MEDICINE, ME
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-798-5588
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/18/2015

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: 207R00000X , with the licence number:  BP10052922 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: T1787 , 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: 592014 . This is a "TEXAS MEDICAL BOARD PHYSICIAN IN TRAINING" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".