Provider Demographics
NPI:1962467878
Name:PANDIT, RAHUL T (MD)
Entity Type:Individual
Prefix:DR
First Name:RAHUL
Middle Name:T
Last Name:PANDIT
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 1:6560 FANNIN ST
Mailing Address - Street 2:SUITE 450
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2761
Mailing Address - Country:US
Mailing Address - Phone:713-441-8843
Mailing Address - Fax:
Practice Address - Street 1:6560 FANNIN ST
Practice Address - Street 2:SUITE 450
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2761
Practice Address - Country:US
Practice Address - Phone:713-441-8843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7091207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX192065403Medicaid
TX1962467878OtherBLUE CROSS BLUE SHIELD
TXP01063019OtherRAILROAD MEDICARE
TX192065402Medicaid
TXP00837101OtherMEDICARE RAILROAD
TXP00837101OtherMEDICARE RAILROAD
TX8B3543Medicare ID - Type Unspecified
TXTXB151277Medicare PIN
H60072Medicare UPIN