Provider Demographics
NPI:1316044126
Name:AGRAHARKAR, ARUNA M (MD)
Entity Type:Individual
Prefix:MRS
First Name:ARUNA
Middle Name:M
Last Name:AGRAHARKAR
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 1:2301 CARINA CT
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-2879
Mailing Address - Country:US
Mailing Address - Phone:281-554-5445
Mailing Address - Fax:281-316-1385
Practice Address - Street 1:2301 CARINA CT
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-2879
Practice Address - Country:US
Practice Address - Phone:281-554-5445
Practice Address - Fax:281-316-1385
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6789207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX030467701Medicaid
TX00503JMedicare PIN
TX030467701Medicaid