Provider Demographics
NPI:1043935844
Name:RAJAN, MASHAER SUNBUL
Entity Type:Individual
Prefix:
First Name:MASHAER
Middle Name:SUNBUL
Last Name:RAJAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 ISLAND FALLS DR
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182-6203
Mailing Address - Country:US
Mailing Address - Phone:817-806-7879
Mailing Address - Fax:
Practice Address - Street 1:3144 HORIZON RD STE 210
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-7047
Practice Address - Country:US
Practice Address - Phone:972-771-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical