Provider Demographics
NPI:1477502235
Name:RAJAN, GEETA (MD)
Entity Type:Individual
Prefix:DR
First Name:GEETA
Middle Name:
Last Name:RAJAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 OLD SHEPARD PL # 406
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5279
Mailing Address - Country:US
Mailing Address - Phone:972-867-3535
Mailing Address - Fax:972-867-3530
Practice Address - Street 1:4601 OLD SHEPARD PL # 406
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5279
Practice Address - Country:US
Practice Address - Phone:972-867-3535
Practice Address - Fax:972-867-3530
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK51872084N0400X, 2084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173530001Medicaid
TX2047244OtherUHC
TX5952552OtherAETNA
TX8M7220OtherBCBS
TXK5187OtherTEXAS LICENSE
TX8C0433Medicare ID - Type Unspecified
TX173530001Medicaid