Kanthi Raju, D.o., P.a. | |
275 W Campbell Rd Suite 430 Richardson TX 75080-3601 | |
(972) 918-0170 | |
Not Available |
Full Name | Kanthi Raju, D.o., P.a. |
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Speciality | Psychiatry & Neurology |
Location | 275 W Campbell Rd, Richardson, Texas |
Authorized Official Name and Position | Kanthi P. Raju (D.O.) |
Authorized Official Contact | 9729180170 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Kanthi Raju, D.o., P.a. Po Box 1171 Addison TX 75001-1171 Ph: (972) 991-9950 | Kanthi Raju, D.o., P.a. 275 W Campbell Rd Suite 430 Richardson TX 75080-3601 Ph: (972) 918-0170 |
NPI Number | 1114186947 |
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Provider Enumeration Date | 06/06/2008 |
Last Update Date | 07/28/2008 |
Medicare PECOS PAC ID | 0547332017 |
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Medicare Enrollment ID | O20080630000104 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114186947 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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2084P0800X | Psychiatry & Neurology - Psychiatry | K1905 (Texas) | Primary |
Provider Name | Kanthi P Raju |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1124039144 PECOS PAC ID: 2668384876 Enrollment ID: I20031105000103 |
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