Provider Demographics
NPI:1528096898
Name:NARAYANAN, RADHA P (MD)
Entity type:Individual
Prefix:DR
First Name:RADHA
Middle Name:P
Last Name:NARAYANAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 PALUXY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76048-5689
Mailing Address - Country:US
Mailing Address - Phone:817-579-3902
Mailing Address - Fax:817-579-3901
Practice Address - Street 1:1308 PALUXY RD STE 300
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048-5689
Practice Address - Country:US
Practice Address - Phone:817-579-3902
Practice Address - Fax:817-579-3901
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0144207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170092404Medicaid
TX170092401Medicaid
TX170092402Medicaid
TXP00196345Medicare PIN
F87188Medicare UPIN
TX170092401Medicaid
TX8C9691Medicare PIN