Provider Demographics
NPI:1316947443
Name:AGGARWAL, AJAY KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:AJAY
Middle Name:KUMAR
Last Name:AGGARWAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:A
Other - Middle Name:
Other - Last Name:J
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 271682
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77277-1682
Mailing Address - Country:US
Mailing Address - Phone:713-663-7246
Mailing Address - Fax:281-201-4560
Practice Address - Street 1:2010 NAOMI ST STE A600
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-3835
Practice Address - Country:US
Practice Address - Phone:713-663-7246
Practice Address - Fax:713-588-8617
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3418207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX131822204Medicaid
TX8G2801OtherBC/BS
TX00K13MOtherMEDICARE PTAN
TX8F2574OtherBC/BS
TX8X1190OtherBC/BS
TXJ3418OtherSTATE LICENSE
TX131822204Medicaid