Provider Demographics
NPI:1609210285
Name:VENKATESAN, ROHIT (MD)
Entity Type:Individual
Prefix:
First Name:ROHIT
Middle Name:
Last Name:VENKATESAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0565
Mailing Address - Country:US
Mailing Address - Phone:409-772-1164
Mailing Address - Fax:409-772-3533
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-0565
Practice Address - Country:US
Practice Address - Phone:409-772-1164
Practice Address - Fax:409-772-3533
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-25
Last Update Date:2023-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10047128207R00000X
TXR7920207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX386401902Medicaid
TX386401903OtherMEDICAID CSHCN