Provider Demographics
NPI:1952347858
Name:RAJ, VEENA N (DMD)
Entity Type:Individual
Prefix:
First Name:VEENA
Middle Name:N
Last Name:RAJ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 SARATOGA BLVD BLDG 1
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-3477
Mailing Address - Country:US
Mailing Address - Phone:361-992-9500
Mailing Address - Fax:361-992-1862
Practice Address - Street 1:13725 NORTHWEST BLVD STE 270
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-5123
Practice Address - Country:US
Practice Address - Phone:361-992-9500
Practice Address - Fax:361-992-1862
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33541122300000X, 1223G0001X
IN12010836A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist