Provider Demographics
NPI:1356674584
Name:NIRAJ CHOUDHARY MD PA
Entity Type:Organization
Organization Name:NIRAJ CHOUDHARY MD PA
Other - Org Name:PRIMARY CARE CENTER OF CLEAR LAKE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SMRITI
Authorized Official - Middle Name:DUBEY
Authorized Official - Last Name:CHOUDHARY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-416-8987
Mailing Address - Street 1:360 E MEDICAL CENTER BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4321
Mailing Address - Country:US
Mailing Address - Phone:832-932-5669
Mailing Address - Fax:832-932-5249
Practice Address - Street 1:360 E MEDICAL CENTER BLVD STE A
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4321
Practice Address - Country:US
Practice Address - Phone:832-932-5669
Practice Address - Fax:832-932-5249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-04
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2845207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty