Provider Demographics
NPI:1093145070
Name:AKULA, RAJ KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJ
Middle Name:KUMAR
Last Name:AKULA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 E HAWKINS PKWY
Mailing Address - Street 2:APT 6301
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-8002
Mailing Address - Country:US
Mailing Address - Phone:732-668-4194
Mailing Address - Fax:
Practice Address - Street 1:1130 E HAWKINS PKWY
Practice Address - Street 2:APT 6301
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-8002
Practice Address - Country:US
Practice Address - Phone:732-668-4194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-12
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ7998207R00000X, 208M00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program