Provider Demographics
NPI:1437137981
Name:RATHOD, MINAXI K (MD)
Entity Type:Individual
Prefix:DR
First Name:MINAXI
Middle Name:K
Last Name:RATHOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MINAXI
Other - Middle Name:K
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:STE 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:2006-01-05
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG6377207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5000182OtherAETNA PIN
TX82A930OtherBLUE SHIELD, TEXAS
OK100048080AMedicaid
TX113236702Medicaid
TX440002178OtherRAILROAD MEDICARE PIN
TX82A930OtherBLUE SHIELD, TEXAS
TX82A930Medicare PIN
TX$$$$$$$$$OtherTRICARE PIN (CHAMPUS)