Provider Demographics
NPI:1104000629
Name:SHENAVA, RAJESH GOPAL (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJESH
Middle Name:GOPAL
Last Name:SHENAVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7941 KATY FWY # 214
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1924
Mailing Address - Country:US
Mailing Address - Phone:713-868-3333
Mailing Address - Fax:713-868-3338
Practice Address - Street 1:1801 NORTH LOOP W
Practice Address - Street 2:SUITE 35
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1444
Practice Address - Country:US
Practice Address - Phone:713-869-3333
Practice Address - Fax:713-869-3338
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-19
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN4091207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1152943Medicaid
LA1152943Medicaid
TXTXB109978Medicare PIN
LA4N571Medicare PIN