Provider Demographics
NPI:1093503963
Name:JAISY RAJU
Entity type:Organization
Organization Name:JAISY RAJU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JAISY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJU
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP-BC
Authorized Official - Phone:469-691-2288
Mailing Address - Street 1:398 REDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182-3239
Mailing Address - Country:US
Mailing Address - Phone:469-691-2288
Mailing Address - Fax:469-691-2289
Practice Address - Street 1:398 REDSTONE DR
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-3239
Practice Address - Country:US
Practice Address - Phone:469-691-2288
Practice Address - Fax:469-691-2289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care