Provider Demographics
NPI:1548419179
Name:NAGARAJAN, VIJAIGANESH (MBBS, MD)
Entity Type:Individual
Prefix:DR
First Name:VIJAIGANESH
Middle Name:
Last Name:NAGARAJAN
Suffix:
Gender:M
Credentials:MBBS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UT PHYSICIANS CLINIC
Mailing Address - Street 2:5115 AVENUE H STE 701
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-2013
Mailing Address - Country:US
Mailing Address - Phone:713-486-1950
Mailing Address - Fax:713-486-0857
Practice Address - Street 1:UT PHYSICIANS CLINIC
Practice Address - Street 2:5115 AVENUE H STE 701
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-2013
Practice Address - Country:US
Practice Address - Phone:713-486-1950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ8311207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3104607Medicaid
OH3104607Medicaid