Provider Demographics
NPI:1205026416
Name:RAJEEV SAREEN, MD
Entity Type:Organization
Organization Name:RAJEEV SAREEN, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER ENROLLMENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:KIGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-614-0181
Mailing Address - Street 1:PO BOX 2300
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78298-2300
Mailing Address - Country:US
Mailing Address - Phone:210-614-0180
Mailing Address - Fax:210-614-1722
Practice Address - Street 1:1905 HIGHWAY 97 E
Practice Address - Street 2:EMERGENCY ROOM
Practice Address - City:JOURDANTON
Practice Address - State:TX
Practice Address - Zip Code:78026-1504
Practice Address - Country:US
Practice Address - Phone:830-769-4301
Practice Address - Fax:830-281-8521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1382207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXOOX832Medicare PIN