Provider Demographics
NPI:1790194041
Name:MAHARAJ K. RAZDAN
Entity Type:Organization
Organization Name:MAHARAJ K. RAZDAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHARAJ
Authorized Official - Middle Name:K
Authorized Official - Last Name:RAZDAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-682-8944
Mailing Address - Street 1:222 E RIDGE RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1251
Mailing Address - Country:US
Mailing Address - Phone:956-682-8944
Mailing Address - Fax:956-682-8454
Practice Address - Street 1:222 E RIDGE RD
Practice Address - Street 2:SUITE 115
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1251
Practice Address - Country:US
Practice Address - Phone:956-682-8944
Practice Address - Fax:956-682-8454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF2416261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133888106Medicaid
TX00G68ZMedicare PIN
TX133888106Medicaid