Provider Demographics
NPI:1942256698
Name:KUMAR, RAJESHWAR (MD)
Entity Type:Individual
Prefix:
First Name:RAJESHWAR
Middle Name:
Last Name:KUMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N ALLEN DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-2555
Mailing Address - Country:US
Mailing Address - Phone:972-390-8722
Mailing Address - Fax:972-390-8496
Practice Address - Street 1:400 N ALLEN DR
Practice Address - Street 2:SUITE 201
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-2555
Practice Address - Country:US
Practice Address - Phone:972-390-8722
Practice Address - Fax:972-390-8496
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK 4474207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX752759433OtherTAX ID
TX00069GMedicare ID - Type Unspecified
TX752759433OtherTAX ID