Provider Demographics
NPI:1396017976
Name:BABAK REJAIE MD PA
Entity Type:Organization
Organization Name:BABAK REJAIE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:WOBBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-317-8103
Mailing Address - Street 1:668 BUNKER HILL RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-5119
Mailing Address - Country:US
Mailing Address - Phone:713-467-2313
Mailing Address - Fax:281-616-6454
Practice Address - Street 1:668 BUNKER HILL RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-5119
Practice Address - Country:US
Practice Address - Phone:713-467-2313
Practice Address - Fax:281-616-6454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7565208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty