Provider Demographics
NPI:1598407017
Name:RAJIV AGARWAL MD PA
Entity Type:Organization
Organization Name:RAJIV AGARWAL MD PA
Other - Org Name:MODERN REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJIV
Authorized Official - Middle Name:
Authorized Official - Last Name:AGARWAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-644-8930
Mailing Address - Street 1:18980 W MEMORIAL DR
Mailing Address - Street 2:STE 100
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338
Mailing Address - Country:US
Mailing Address - Phone:832-644-8930
Mailing Address - Fax:855-227-3506
Practice Address - Street 1:18648 MCKAY DR STE 110
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-5724
Practice Address - Country:US
Practice Address - Phone:831-644-8930
Practice Address - Fax:855-227-3506
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAJIV AGARWAL MD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-13
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0404XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Cardiac FacilitiesGroup - Multi-Specialty