Provider Demographics
NPI:1386098283
Name:BHARATH G RAJ
Entity type:Organization
Organization Name:BHARATH G RAJ
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BHARATH
Authorized Official - Middle Name:GURURAJ
Authorized Official - Last Name:RAJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-410-4602
Mailing Address - Street 1:3411 CEDAR KNOLLS DR STE B
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-2474
Mailing Address - Country:US
Mailing Address - Phone:281-532-5462
Mailing Address - Fax:877-796-5317
Practice Address - Street 1:3411 CEDAR KNOLLS DR STE B
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2474
Practice Address - Country:US
Practice Address - Phone:281-532-5462
Practice Address - Fax:877-796-5317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-17
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Single Specialty