Provider Demographics
NPI:1043296353
Name:PUTCHA, RAJESH V (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJESH
Middle Name:V
Last Name:PUTCHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 35269
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-0269
Mailing Address - Country:US
Mailing Address - Phone:214-424-2213
Mailing Address - Fax:214-231-2159
Practice Address - Street 1:5236 W UNIVERSITY DR
Practice Address - Street 2:#3300
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-7889
Practice Address - Country:US
Practice Address - Phone:972-562-4430
Practice Address - Fax:972-529-2763
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK3630207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX045522202Medicaid
TX8F7160OtherBCBS
TX8F7160OtherBCBS
TX045522202Medicaid
TXG95530Medicare UPIN