Provider Demographics
NPI:1821172354
Name:AJMANI, SURAINDER K (MD)
Entity Type:Individual
Prefix:DR
First Name:SURAINDER
Middle Name:K
Last Name:AJMANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12121 RICHMOND AVE
Mailing Address - Street 2:SUITE# 409
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2432
Mailing Address - Country:US
Mailing Address - Phone:281-493-4922
Mailing Address - Fax:281-493-9728
Practice Address - Street 1:12121 RICHMOND AVE
Practice Address - Street 2:SUITE# 409
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2432
Practice Address - Country:US
Practice Address - Phone:281-493-4922
Practice Address - Fax:281-493-9728
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE2431207R00000X, 207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX117917802Medicaid
TX110232543OtherRAILROAD MEDICARE
TX874541OtherBLUE CROSS
TX110232543OtherRAILROAD MEDICARE
TXB20819Medicare UPIN