Provider Demographics
NPI:1255637757
Name:RAJA, MUHAMMAD-RIZWAN ALTAF (NP)
Entity type:Individual
Prefix:MR
First Name:MUHAMMAD-RIZWAN
Middle Name:ALTAF
Last Name:RAJA
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5550 KELLEY ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77026-1818
Mailing Address - Country:US
Mailing Address - Phone:713-566-9247
Mailing Address - Fax:
Practice Address - Street 1:5550 KELLEY ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77026-1818
Practice Address - Country:US
Practice Address - Phone:713-218-2697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX737294363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP118798OtherTEXAS BOARD OF NURSING
2009010776OtherAMERICAN NURSES CREDENTIALING CENTER
TX737294OtherSTATE LICENSE
TXB0179581OtherTEXAS DEPARTMENT OF PUBLIC SAFETY
MR2353679OtherUS DEPARTMENT OF JUSTICE DRUG ENFORCEMENT ADMINISTRATION