Provider Demographics
NPI:1306002381
Name:NATESAN, RAJNI (MD)
Entity Type:Individual
Prefix:
First Name:RAJNI
Middle Name:
Last Name:NATESAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 HOLCOMBE BLVD
Mailing Address - Street 2:UNIT 1350
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4000
Mailing Address - Country:US
Mailing Address - Phone:713-745-5560
Mailing Address - Fax:713-563-9779
Practice Address - Street 1:1515 HOLCOMBE BLVD
Practice Address - Street 2:UNIT 1350
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4000
Practice Address - Country:US
Practice Address - Phone:713-745-5574
Practice Address - Fax:713-563-9779
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ14602085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX339824001Medicaid
TX372234YKQHMedicare PIN