Provider Demographics
NPI: | 1255433876 |
---|---|
Name: | PARIKH, RAJENDRA C (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | RAJENDRA |
Middle Name: | C |
Last Name: | PARIKH |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | PO BOX 26726 |
Mailing Address - Street 2: | |
Mailing Address - City: | AUSTIN |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 78755-0726 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 512-407-8686 |
Mailing Address - Fax: | 512-406-6216 |
Practice Address - Street 1: | 940 HESTERS CROSSING |
Practice Address - Street 2: | |
Practice Address - City: | ROUND ROCK |
Practice Address - State: | TX |
Practice Address - Zip Code: | 78681-8018 |
Practice Address - Country: | US |
Practice Address - Phone: | 512-244-9024 |
Practice Address - Fax: | 512-218-3704 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-09-03 |
Last Update Date: | 2011-10-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MO | R1E98 | 208000000X |
TX | G2801 | 208000000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
TX | 182669508 | Medicaid | |
TX | 182669509 | Medicaid | |
TX | 182669512 | Medicaid | |
TX | 182669513 | Medicaid | |
TX | 182669508 | Medicaid | |
TX | 8K8764 | Medicare PIN | |
TX | TXB131124 | Medicare PIN | |
TX | 8K8741 | Medicare PIN |