Provider Demographics
NPI:1932683745
Name:GAJERA, KAJAL
Entity Type:Individual
Prefix:
First Name:KAJAL
Middle Name:
Last Name:GAJERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4350 OLD OMEN RD APT 6302
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75707-2544
Mailing Address - Country:US
Mailing Address - Phone:469-274-6473
Mailing Address - Fax:
Practice Address - Street 1:5640 SAINT THOMAS DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75094-4619
Practice Address - Country:US
Practice Address - Phone:469-274-6473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program