Provider Demographics
NPI:1649486168
Name:AGARWAL, RAJIV (MD)
Entity type:Individual
Prefix:
First Name:RAJIV
Middle Name:
Last Name:AGARWAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:18980 W MEMORIAL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4472
Mailing Address - Country:US
Mailing Address - Phone:832-644-8930
Mailing Address - Fax:855-227-3506
Practice Address - Street 1:18980 W MEMORIAL DR STE 100
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4559
Practice Address - Country:US
Practice Address - Phone:832-644-8930
Practice Address - Fax:855-227-3506
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3901163WC3500X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No163WC3500XNursing Service ProvidersRegistered NurseCardiac Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150576005Medicaid
TX1649486168OtherNPI
TX8B5773OtherBCBS
TX1720550015OtherGROUP NPI
TX261QR0404XOtherCARDIAC REHABILITATION TAXONOMY