Provider Demographics
NPI:1427056449
Name:DAHIYA, RAJIV S (MD)
Entity type:Individual
Prefix:
First Name:RAJIV
Middle Name:S
Last Name:DAHIYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 TX-114 FRONTAGE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TROPHY CLUB
Mailing Address - State:TX
Mailing Address - Zip Code:76262
Mailing Address - Country:US
Mailing Address - Phone:817-778-4481
Mailing Address - Fax:682-237-2491
Practice Address - Street 1:2800 TX-114 FRONTAGE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:TROPHY CLUB
Practice Address - State:TX
Practice Address - Zip Code:76262
Practice Address - Country:US
Practice Address - Phone:817-778-4481
Practice Address - Fax:682-237-2491
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8504207R00000X, 2085R0001X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00015003OtherRR MEDICARE
1B1516OtherMEDICARE
TX8A0576Medicare PIN
TXP00015003OtherRR MEDICARE