Provider Demographics
NPI:1801866611
Name:RAO, RAJESH (DO)
Entity Type:Individual
Prefix:
First Name:RAJESH
Middle Name:
Last Name:RAO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14806 HONEYMOON BRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-2138
Mailing Address - Country:US
Mailing Address - Phone:281-242-4754
Mailing Address - Fax:281-242-4754
Practice Address - Street 1:12345 KATY FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-1503
Practice Address - Country:US
Practice Address - Phone:281-679-5600
Practice Address - Fax:281-679-5600
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0532207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX140842908Medicaid
TX8G4157OtherBC/BS PROVIDER NUMBER
TX1404842910Medicaid
TX140842911Medicaid
TX140842911Medicaid
TX140842908Medicaid
TX1404842910Medicaid
TXTXB108287Medicare PIN