Provider Demographics
NPI:1275634289
Name:RETHNAM, RAJESH (MD, FCCP)
Entity Type:Individual
Prefix:
First Name:RAJESH
Middle Name:
Last Name:RETHNAM
Suffix:
Gender:M
Credentials:MD, FCCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 W 26TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1452
Mailing Address - Country:US
Mailing Address - Phone:888-958-6463
Mailing Address - Fax:832-529-6463
Practice Address - Street 1:1800 W 26TH ST STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1452
Practice Address - Country:US
Practice Address - Phone:888-958-6463
Practice Address - Fax:832-529-6463
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2023-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN4033207RB0002X, 207RC0200X
TXN 4033207R00000X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXN4033OtherSTATE LICENSE