Provider Demographics
NPI:1003884511
Name:PLANO NEUROLOGY, PA
Entity Type:Organization
Organization Name:PLANO NEUROLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEETA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-867-3535
Mailing Address - Street 1:4601 OLD SHEPARD PL
Mailing Address - Street 2:#406
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5279
Mailing Address - Country:US
Mailing Address - Phone:972-867-3535
Mailing Address - Fax:972-867-3530
Practice Address - Street 1:4601 OLD SHEPARD PL
Practice Address - Street 2:#406
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5279
Practice Address - Country:US
Practice Address - Phone:972-867-3535
Practice Address - Fax:972-867-3530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-09
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK51872084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0004LMOtherBCBS
TX036972002Medicaid
TX036972002Medicaid