Provider Demographics
NPI:1689679557
Name:RAIJMAN, ISAAC L (MD)
Entity Type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:L
Last Name:RAIJMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 S SHEPHERD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-5316
Mailing Address - Country:US
Mailing Address - Phone:713-795-4444
Mailing Address - Fax:713-795-5254
Practice Address - Street 1:4100 S SHEPHERD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-5316
Practice Address - Country:US
Practice Address - Phone:713-795-4444
Practice Address - Fax:713-795-5254
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7210207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148009701Medicaid
TX00998RMedicare ID - Type UnspecifiedDAH GROUP #
TX148009701Medicaid