Provider Demographics
NPI:1144398264
Name:RAJA ABUSHARR MD PA
Entity Type:Organization
Organization Name:RAJA ABUSHARR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABUSHARR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-204-1864
Mailing Address - Street 1:10110 WOODLANDS PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-2902
Mailing Address - Country:US
Mailing Address - Phone:281-419-6565
Mailing Address - Fax:281-419-0808
Practice Address - Street 1:10110 WOODLANDS PKWY STE 100
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-2902
Practice Address - Country:US
Practice Address - Phone:281-419-6565
Practice Address - Fax:281-419-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3126207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00X146Medicare PIN
TXH83671Medicare UPIN