1487749909 NPI number — GANESH N RAJAMANI DPT

Table of content: GANESH N RAJAMANI DPT (NPI 1487749909)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487749909 NPI number — GANESH N RAJAMANI DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAJAMANI
Provider First Name:
GANESH
Provider Middle Name:
N
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DPT
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:
1487749909
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/29/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 58538
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEBSTER
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77598-8538
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-554-9885
Provider Business Mailing Address Fax Number:
281-554-9887

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
526 ORCHARD ST STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEBSTER
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77598-4110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-554-9885
Provider Business Practice Location Address Fax Number:
281-554-9887
Provider Enumeration Date:
10/03/2006

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: 225100000X , with the licence number:  1083491 , 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: 0083777 . This is a "BCBS HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8T1764 . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 3291703 . This is a "AETNA HMO" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 320077987001 . This is a "HUMANA TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7851518 . This is a "AETNA NON-HMO" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 160384701 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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