Provider Demographics
NPI:1013906684
Name:CHOUDHARY, NIRAJ (MD)
Entity Type:Individual
Prefix:
First Name:NIRAJ
Middle Name:
Last Name:CHOUDHARY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:NIRAJ
Other - Middle Name:
Other - Last Name:CHOUDHARY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:360 E MEDICAL CENTER BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4321
Mailing Address - Country:US
Mailing Address - Phone:832-932-5669
Mailing Address - Fax:832-932-5249
Practice Address - Street 1:360 E MEDICAL CENTER BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4321
Practice Address - Country:US
Practice Address - Phone:832-932-5669
Practice Address - Fax:832-932-5249
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2845207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX152735001Medicaid
H65372Medicare UPIN
TXOA5315Medicare PIN