Provider Demographics
NPI:1043788789
Name:JAISWAL, RAJESHRE (MS OT)
Entity Type:Individual
Prefix:
First Name:RAJESHRE
Middle Name:
Last Name:JAISWAL
Suffix:
Gender:F
Credentials:MS OT
Other - Prefix:
Other - First Name:RAJESHREE
Other - Middle Name:
Other - Last Name:SHIVHARE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1910 JOURDAN WAY
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-5562
Mailing Address - Country:US
Mailing Address - Phone:281-804-9759
Mailing Address - Fax:
Practice Address - Street 1:6621 FANNIN ST # B21329
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2358
Practice Address - Country:US
Practice Address - Phone:832-826-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-12
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107957225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand