Provider Demographics
NPI:1235226473
Name:V.S.ARJUNRAJ FAMILY MEDICINE P.A
Entity Type:Organization
Organization Name:V.S.ARJUNRAJ FAMILY MEDICINE P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEEPALAKSHMI
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJAKRISHNAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-619-1770
Mailing Address - Street 1:6053 MAIN ST
Mailing Address - Street 2:SUITE #230
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-2062
Mailing Address - Country:US
Mailing Address - Phone:214-619-1770
Mailing Address - Fax:214-619-1775
Practice Address - Street 1:6053 MAIN ST
Practice Address - Street 2:SUITE #230
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-2062
Practice Address - Country:US
Practice Address - Phone:214-619-1770
Practice Address - Fax:214-619-1775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2760207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI 18506Medicare UPIN