Provider Demographics
NPI:1407380371
Name:RAJU, FEBIN BETHEL (RT(R)(CT)(ARRT))
Entity Type:Individual
Prefix:
First Name:FEBIN
Middle Name:BETHEL
Last Name:RAJU
Suffix:
Gender:M
Credentials:RT(R)(CT)(ARRT)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 731416
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-1416
Mailing Address - Country:US
Mailing Address - Phone:713-244-5179
Mailing Address - Fax:832-383-6962
Practice Address - Street 1:9301 SOUTHWEST FWY
Practice Address - Street 2:SUITE 155
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1510
Practice Address - Country:US
Practice Address - Phone:713-244-5179
Practice Address - Fax:832-383-6962
Is Sole Proprietor?:No
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXGMR00094624247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist