Provider Demographics
NPI:1184760332
Name:NOOR GAJRAJ, MD
Entity type:Organization
Organization Name:NOOR GAJRAJ, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NOOR
Authorized Official - Middle Name:M
Authorized Official - Last Name:GAJRAJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-210-9990
Mailing Address - Street 1:4412 COLUMBIA RD
Mailing Address - Street 2:STE 106
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-4562
Mailing Address - Country:US
Mailing Address - Phone:706-210-9990
Mailing Address - Fax:706-210-0771
Practice Address - Street 1:1111 GALLAGHER DR
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-1713
Practice Address - Country:US
Practice Address - Phone:903-870-7000
Practice Address - Fax:903-870-7188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Not Answered207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00253480OtherRAILROAD MEDICARE
TX0059MTOtherBCBS OF TX
TX=========OtherTRICARE
TXP00253480OtherRAILROAD MEDICARE