Provider Demographics
NPI:1851326730
Name:JORGE A RAICHMAN MD PA
Entity Type:Organization
Organization Name:JORGE A RAICHMAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAICHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-772-6519
Mailing Address - Street 1:7500 BEECHNUT ST
Mailing Address - Street 2:SUITE 214
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074
Mailing Address - Country:US
Mailing Address - Phone:713-772-6519
Mailing Address - Fax:713-271-9943
Practice Address - Street 1:7500 BEECHNUT ST
Practice Address - Street 2:SUITE 214
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074
Practice Address - Country:US
Practice Address - Phone:713-772-6519
Practice Address - Fax:713-271-9943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG28182084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX128838304Medicaid
TXTJ80OtherBCBS
10015968OtherAMERIGROUP
260002499OtherRAILROAD MEDICARE
TX128838304Medicaid
TJ80Medicare ID - Type Unspecified