Provider Demographics
NPI:1306928098
Name:PURI, RAHUL DINESH (MD)
Entity type:Individual
Prefix:DR
First Name:RAHUL
Middle Name:DINESH
Last Name:PURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:ANDREWS
Mailing Address - State:TX
Mailing Address - Zip Code:79714-3638
Mailing Address - Country:US
Mailing Address - Phone:432-523-6624
Mailing Address - Fax:432-524-1147
Practice Address - Street 1:700 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:TX
Practice Address - Zip Code:79714-3638
Practice Address - Country:US
Practice Address - Phone:432-523-6624
Practice Address - Fax:432-524-1147
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8837207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1306928098OtherNPI
TX281172101Medicaid
TXTXB126765OtherMEDICARE TXB126765
TXTXB126765OtherMEDICARE TXB126765
TX281172101Medicaid