Provider Demographics
NPI:1336127927
Name:RATHOD, KAMALSINGH M (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMALSINGH
Middle Name:M
Last Name:RATHOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KAMAL
Other - Middle Name:
Other - Last Name:RATHOD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:321 N HIGHLAND AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-7386
Mailing Address - Country:US
Mailing Address - Phone:903-893-1011
Mailing Address - Fax:866-240-2131
Practice Address - Street 1:321 N HIGHLAND AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-7386
Practice Address - Country:US
Practice Address - Phone:903-893-1011
Practice Address - Fax:866-240-2131
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4690207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX129608901Medicaid
TX82A929OtherBLUE SHIELD, TEXAS
TX060049872OtherRAILROAD MEDICARE PIN
TX4355331OtherAETNA PIN
TX129608901Medicaid
TX$$$$$$$$$OtherTRICARE PIN (CHAMPUS)
TX82A929OtherBLUE SHIELD, TEXAS